Provider Demographics
NPI:1629942826
Name:BACK HOME CHIROPRACTIC AND WELLNESS LLC
Entity type:Organization
Organization Name:BACK HOME CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-380-1709
Mailing Address - Street 1:139 N LAWLER ST
Mailing Address - Street 2:
Mailing Address - City:POSTVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52162-7799
Mailing Address - Country:US
Mailing Address - Phone:563-863-3070
Mailing Address - Fax:
Practice Address - Street 1:139 N LAWLER ST
Practice Address - Street 2:
Practice Address - City:POSTVILLE
Practice Address - State:IA
Practice Address - Zip Code:52162-7799
Practice Address - Country:US
Practice Address - Phone:563-863-3070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty