MEDICARE: BACK TO HEALTH PLLC

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	:	1750923355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK TO HEALTH PLLC

Provider Business Mailing Address
First Line	:	4101 E LOUISIANA AVE STE 340
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-3449
Country	:	US
Telephone Number	:	303-399-1798
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 E LOUISIANA AVE STE 340
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-3449
Country	:	US
Telephone Number	:	303-399-1798
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER MICHAEL KEIRNAN
Credential	:	DC
Telephone Number	:	303-399-1798

Provider Enumeration Date	:	10/15/2019
Last Update Date	:	10/15/2019

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Directions to “BACK TO HEALTH PLLC ” Practice Location

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