Healthcare Provider Details

I. General information

NPI: 1073793436
Provider Name (Legal Business Name): BACK TO HEALTH CHIROPRACTIC OF RANGELY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2007
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W MAIN ST STE 135
RANGELY CO
81648-2408
US

IV. Provider business mailing address

PO BOX 666
RANGELY CO
81648-0666
US

V. Phone/Fax

Practice location:
  • Phone: 970-675-2273
  • Fax: 970-675-2273
Mailing address:
  • Phone: 970-675-2273
  • Fax: 970-675-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4463
License Number StateCO

VIII. Authorized Official

Name: DR. JOYCE K MULLER
Title or Position: OWNER
Credential: D.C.
Phone: 970-675-2273