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General NPI Number Information
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NPI Number | 1568596286
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Entity Type | Organization
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Legal Business Name | BACK AND BODY CHIROPRACTIC CENTER INC.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 69 HUSTONVILLE STREET
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City | LIBERTY
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State | KY
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Zip | 42539
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Country | US
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Telephone | 606-787-2800
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Fax | 606-787-2880
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | LIBERTY
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State | KY
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Zip | 42539-0340
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Country | US
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Telephone | 606-787-2800
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Fax | 606-787-2880
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ERICA LYNN MONTGOMERY-TURNER
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Credential | D.C.
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Telephone | 606-787-2800
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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 | KY4614
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License Number State | KY
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