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General NPI Number Information
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NPI Number | 1821598731
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Entity Type | Organization
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Legal Business Name | BACK TO NORMAL, LLC
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 217 E INTENDENCIA ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6022
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Country | US
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Telephone | 850-437-1937
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Fax | 800-785-5684
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Provider Business Mailing Address
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Address Line | 217 E INTENDENCIA ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6022
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Country | US
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Telephone | 850-512-0711
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Fax | 800-785-5684
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CASEY A DULL
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Credential |
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Telephone | 850-437-1937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PT18460
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License Number State | FL
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