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General NPI Number Information
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NPI Number | 1407910805
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Entity Type | Organization
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Legal Business Name | BACK IN MOTION CHIRO & REHAB CTR LLC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 718 N HEINCKE RD
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City | MIAMISBURG
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State | OH
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Zip | 45342-2742
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Country | US
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Telephone | 937-859-0166
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Fax | 937-859-0401
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Provider Business Mailing Address
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Address Line | PO BOX 750668
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City | DAYTON
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State | OH
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Zip | 45475-0668
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Country | US
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Telephone | 937-859-0166
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Fax | 937-859-0401
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Authorized Official
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Title or Position | OWNER
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Name | DR. HENRY N KUNTZ
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Credential | D.C.
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Telephone | 937-859-0166
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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 | 2548
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License Number State | OH
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