Provider Demographics
NPI:1831976224
Name:BACK BETTER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BACK BETTER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:182-828-3940
Mailing Address - Street 1:17245 SE 158TH AVE
Mailing Address - Street 2:
Mailing Address - City:WEIRSDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32195-3112
Mailing Address - Country:US
Mailing Address - Phone:182-828-3940
Mailing Address - Fax:
Practice Address - Street 1:1111 NE 25TH AVE STE 504
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5669
Practice Address - Country:US
Practice Address - Phone:352-509-6741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty