Healthcare Provider Details
I. General information
NPI: 1841127628
Provider Name (Legal Business Name): BACKCOUNTRY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
323 W MAIN ST STE 202
FRISCO CO
80443-5966
US
IV. Provider business mailing address
PO BOX 8851
AVON CO
81620-8829
US
V. Phone/Fax
- Phone: 970-368-2764
- Fax:
- Phone: 970-368-2764
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALEXANDRA
ALISE
PAUL
Title or Position: CHIROPRACTOR, OWNER
Credential: DC
Phone: 908-566-6336