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General NPI Number Information
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NPI Number | 1306700737
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Entity Type | Organization
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Legal Business Name | BACK TO LIFE CHIROPRACTIC CENTER II
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 3164 HIGHWAY 431 STE 7
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City | ROANOKE
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State | AL
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Zip | 36274-1702
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Country | US
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Telephone | 678-522-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 LAFAYETTE PKWY
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City | LAGRANGE
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State | GA
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Zip | 30241-2513
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Country | US
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Telephone | 706-882-5737
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | TAMMI LYN KAMINSKY
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Credential | DC
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Telephone | 706-882-5737
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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 |
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License Number State |
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