Provider Demographics
NPI:1881975894
Name:BACK CENTER, PLLC
Entity type:Organization
Organization Name:BACK CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEWPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-216-3915
Mailing Address - Street 1:835 HIGHWAY 321 N
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-6433
Mailing Address - Country:US
Mailing Address - Phone:865-216-3915
Mailing Address - Fax:
Practice Address - Street 1:835 HIGHWAY 321 N
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6433
Practice Address - Country:US
Practice Address - Phone:865-216-3915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-03
Last Update Date:2011-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty