Healthcare Provider Details

I. General information

NPI: 1649500596
Provider Name (Legal Business Name): BACK2HEALTH - FRENCH LICK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2009
Last Update Date: 12/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 S MAPLE ST
FRENCH LICK IN
47432
US

IV. Provider business mailing address

567 S MAPLE ST
FRENCH LICK IN
47432-2245
US

V. Phone/Fax

Practice location:
  • Phone: 812-936-6050
  • Fax: 812-936-6051
Mailing address:
  • Phone: 812-936-6050
  • Fax: 812-936-6051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD ALLEN SNIDER
Title or Position: OWNER
Credential: D.C.
Phone: 812-882-1241