Provider Demographics
NPI:1871627612
Name:BACK TO HEALTH P.C.
Entity type:Organization
Organization Name:BACK TO HEALTH P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-582-3424
Mailing Address - Street 1:5555 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2508
Mailing Address - Country:US
Mailing Address - Phone:563-582-3424
Mailing Address - Fax:563-582-3566
Practice Address - Street 1:5555 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:ASBURY
Practice Address - State:IA
Practice Address - Zip Code:52002-2508
Practice Address - Country:US
Practice Address - Phone:563-582-3424
Practice Address - Fax:563-582-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06846111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI20307Medicare PIN