MEDICARE: BACK TO HEALTH CHIROPRACTIC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831378629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO HEALTH CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	82 PARK AVE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1742
Country	:	US
Telephone Number	:	508-752-7521
Fax Number	:	508-798-3418

Provider Business Practice Location Address
First Line	:	82 PARK AVE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1742
Country	:	US
Telephone Number	:	508-752-7521
Fax Number	:	508-798-3418

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. RICHARD DAVID MCNAMARA
Credential	:
Telephone Number	:	508-752-7521

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	09/29/2011

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