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General NPI Number Information
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NPI Number | 1760243778
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Entity Type | Organization
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Legal Business Name | BACK IN MOTION CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 1925 VILLAGE CENTER CIR STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89134-6261
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Country | US
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Telephone | 702-476-9683
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Fax |
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Provider Business Mailing Address
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Address Line | 601 BAYSVILLE CT
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City | LAS VEGAS
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State | NV
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Zip | 89144-4414
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Country | US
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Telephone | 702-378-6755
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY HUNTER ALLEN
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Credential | DC
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Telephone | 702-378-6755
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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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