MEDICARE: THE BACK CARE CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1700477239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BACK CARE CENTER, LLC

Provider Business Mailing Address
First Line	:	24 GRANT AVENUE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628-1630
Country	:	US
Telephone Number	:	201-387-7463
Fax Number	:	201-387-2360

Provider Business Practice Location Address
First Line	:	24 GRANT AVENUE
Second Line	:
City	:	DUMONT
State	:	NJ
Zip	:	07628-1630
Country	:	US
Telephone Number	:	201-387-7463
Fax Number	:	201-387-2360

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DR. DAVID B SCHWARTZ
Credential	:	DC
Telephone Number	:	201-387-7463

Provider Enumeration Date	:	01/28/2021
Last Update Date	:	02/12/2021

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Directions to “THE BACK CARE CENTER, LLC ” Practice Location

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