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General NPI Number Information
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NPI Number | 1609312172
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Entity Type | Organization
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Legal Business Name | BACK TO HEALTH WELLNESS CENTER. INC
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 1651 GALISTEO ST STE 12
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City | SANTA FE
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State | NM
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Zip | 87505-2113
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Country | US
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Telephone | 505-467-8999
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Fax | 505-982-9770
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Provider Business Mailing Address
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Address Line | 1651 GALISTEO ST STE 12
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City | SANTA FE
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State | NM
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Zip | 87505-2113
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Country | US
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Telephone | 505-467-8999
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Fax | 505-982-9770
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | CHAZ SCHATZLE
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Credential | D.C., A.P.C.
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Telephone | 505-467-8999
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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 | 1087
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License Number State | NM
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