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General NPI Number Information
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NPI Number | 1225034754
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Entity Type | Organization
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Legal Business Name | BACK NORTH CHIROPRACTIC CARE PLC
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1127 NORTH AVE STE 21
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City | BURLINGTON
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State | VT
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Zip | 05401-2756
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Country | US
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Telephone | 802-652-0015
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Fax | 802-652-0016
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Provider Business Mailing Address
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Address Line | 1127 NORTH AVE STE 21
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City | BURLINGTON
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State | VT
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Zip | 05401-2756
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Country | US
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Telephone | 802-652-0015
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Fax | 802-652-0016
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. DANIEL S WEBER
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Credential | D.C.
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Telephone | 802-652-0015
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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 | 006-0001138
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License Number State | VT
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