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General NPI Number Information
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NPI Number | 1598270738
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Entity Type | Organization
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Legal Business Name | BACK IN ACTION CHIROPRACTIC, PA
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 903 HIGHWAY 15 S
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City | HUTCHINSON
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State | MN
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Zip | 55350
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Country | US
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Telephone | 320-587-6666
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Fax | 320-587-8244
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Provider Business Mailing Address
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Address Line | 903 HIGHWAY 15 S
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City | HUTCHINSON
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State | MN
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Zip | 55350-3117
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Country | US
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Telephone | 320-587-6666
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Fax | 320-587-8244
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN PAUL SOMERVILLE
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Credential | DC
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Telephone | 320-587-6666
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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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