Provider Demographics
NPI:1831432475
Name:BACK TO NATURAL LLC
Entity type:Organization
Organization Name:BACK TO NATURAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MOLNAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-704-4403
Mailing Address - Street 1:750 N ORLEANS ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5098
Mailing Address - Country:US
Mailing Address - Phone:314-704-4403
Mailing Address - Fax:
Practice Address - Street 1:750 N ORLEANS ST
Practice Address - Street 2:SUITE 303
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-5098
Practice Address - Country:US
Practice Address - Phone:314-704-4403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-02
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011981261QP2000X, 261QR0400X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation