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General NPI Number Information
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NPI Number | 1801089636
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Entity Type | Organization
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Legal Business Name | BACK TO HEALTH CHIROPRACTIC WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 11465 TOEPPERWEIN RD
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City | LIVE OAK
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State | TX
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Zip | 78233-3138
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Country | US
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Telephone | 210-599-9570
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Fax | 210-599-9572
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Provider Business Mailing Address
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Address Line | 11465 TOEPPERWEIN RD
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City | LIVE OAK
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State | TX
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Zip | 78233-3138
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Country | US
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Telephone | 210-599-9570
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Fax | 210-599-9572
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Authorized Official
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Title or Position | CO-OWNER/DOCTOR
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Name | DR. DREW S. CZERMINSKI
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Credential | D.C.
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Telephone | 210-599-9570
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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 | 6948
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License Number State | TX
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