Healthcare Provider Details

I. General information

NPI: 1831831734
Provider Name (Legal Business Name): BACK IN MOTION SPORTS & CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7895 BROADWAY STE E
MERRILLVILLE IN
46410-5529
US

IV. Provider business mailing address

PO BOX 365
HOBART IN
46342-0365
US

V. Phone/Fax

Practice location:
  • Phone: 219-544-5665
  • Fax: 219-209-5455
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. LAKIA SHARAI BROWN
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 219-742-7139