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General NPI Number Information
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NPI Number | 1396931705
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Entity Type | Organization
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Legal Business Name | BACKBONE, LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 7108 PIONEER WAY STE A
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City | GIG HARBOR
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State | WA
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Zip | 98335-1178
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Country | US
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Telephone | 253-858-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 7108 PIONEER WAY STE A
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City | GIG HARBOR
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State | WA
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Zip | 98335-1178
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Country | US
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Telephone | 253-858-2474
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHRISTIAN COHEN
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Credential | DC
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Telephone | 253-858-2474
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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 | CH 00034304
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License Number State | WA
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