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General NPI Number Information
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NPI Number | 1023107133
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Entity Type | Organization
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Legal Business Name | BACK 2 HEALTH WELLNESS CENTER
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1110 C STREET
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City | BRIDGETON
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State | NC
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Zip | 28560
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Country | US
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Telephone | 252-514-0333
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Fax | 252-514-0332
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | BRIDGETON
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State | NC
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Zip | 28519-0005
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Country | US
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Telephone | 252-514-0333
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Fax | 252-514-0332
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD RAY SOLOMON
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Credential | DC
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Telephone | 252-514-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3532
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License Number State | NC
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