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NPI Code Detail

MEDICARE: BACK TO BACK CHIROPRACTIC

MEDICARE: BACK TO BACK CHIROPRACTIC
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
1111N00000XChiropractor26757CA

General Provider Information

NPI Number : 1710251269
Entity Type Code : Organization
Provider Name (Legal Business Name) : BACK TO BACK CHIROPRACTIC
Provider Business Mailing Address
First Line : 1343 BLOSSOM HILL RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-3801
Country : US
Telephone Number : 408-269-2225
Fax Number : 408-979-7878
Provider Business Practice Location Address
First Line : 1343 BLOSSOM HILL RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95118-3801
Country : US
Telephone Number : 408-269-2225
Fax Number : 408-979-7878
Authorized Official
Title or Position : OWNER
Name : DR. MERONEA JANINE LAHANN-CHIVERS
Credential : DC
Telephone Number : 408-269-2225
Provider Enumeration Date : 03/01/2012
Last Update Date : 03/01/2012

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Directions to “BACK TO BACK CHIROPRACTIC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.