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General NPI Number Information
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NPI Number | 1033364195
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Entity Type | Organization
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Legal Business Name | BACK TO HEALTH CHIROPRACTIC CARE
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 12/05/2008
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Provider Practice Location Address
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Address Line | 1077 CASS ST STE C
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City | MONTEREY
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State | CA
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Zip | 93940-4551
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Country | US
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Telephone | 831-373-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 1077 CASS ST STE C
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City | MONTEREY
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State | CA
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Zip | 93940-4551
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Country | US
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Telephone | 831-373-5636
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG KELLEY
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Credential | D.C.
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Telephone | 831-373-5636
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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 | 20658
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License Number State | CA
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