Provider Demographics
NPI:1083590426
Name:BACK TO HEALTH OF VISTANCIA
Entity type:Organization
Organization Name:BACK TO HEALTH OF VISTANCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILLIG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-551-6677
Mailing Address - Street 1:3051 W SOUSA CT
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1700
Mailing Address - Country:US
Mailing Address - Phone:602-676-6306
Mailing Address - Fax:
Practice Address - Street 1:28421 N VISTANCIA BLVD STE A101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2198
Practice Address - Country:US
Practice Address - Phone:602-676-6306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty