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General NPI Number Information
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NPI Number | 1831432475
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Entity Type | Organization
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Legal Business Name | BACK TO NATURAL LLC
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 750 N ORLEANS ST SUITE 303
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City | CHICAGO
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State | IL
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Zip | 60654-5098
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Country | US
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Telephone | 314-704-4403
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Fax |
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Provider Business Mailing Address
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Address Line | 750 N ORLEANS ST SUITE 303
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City | CHICAGO
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State | IL
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Zip | 60654-5098
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Country | US
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Telephone | 314-704-4403
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SARA LYNN MOLNAR
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Credential | D.C.
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Telephone | 314-704-4403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 038.011981
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 038.011981
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 038.011981
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License Number State | IL
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