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General NPI Number Information
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NPI Number | 1235899410
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Entity Type | Organization
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Legal Business Name | BACK TO YOU LLC
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 5157 BUSINESS 220 STE 2
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City | BEDFORD
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State | PA
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Zip | 15522-7770
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Country | US
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Telephone | 814-212-8096
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Fax |
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Provider Business Mailing Address
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Address Line | 5157 BUSINESS 220 STE 2
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City | BEDFORD
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State | PA
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Zip | 15522-7770
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Country | US
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Telephone | 814-212-8096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER FITZSIMMONS
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Credential | CRNP
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Telephone | 814-212-8096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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