Healthcare Provider Details

I. General information

NPI: 1780422923
Provider Name (Legal Business Name): BACK TO BASICS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 KINNELON RD STE 5
KINNELON NJ
07405-2335
US

IV. Provider business mailing address

91 KINNELON RD STE 5
KINNELON NJ
07405-2335
US

V. Phone/Fax

Practice location:
  • Phone: 973-370-0260
  • Fax:
Mailing address:
  • Phone: 973-370-0260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH HOBBY MERRITT
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 973-370-0260