MEDICARE: BACK 2 LIFE HEALTH CENTER

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	4977	CO

General Provider Information

NPI Number	:	1841473626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK 2 LIFE HEALTH CENTER

Provider Business Mailing Address
First Line	:	6265 E EVANS AVE
Second Line	:	SUITE 7
City	:	DENVER
State	:	CO
Zip	:	80222-5817
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6265 E EVANS AVE
Second Line	:	SUITE 7
City	:	DENVER
State	:	CO
Zip	:	80222-5817
Country	:	US
Telephone Number	:	303-692-8803
Fax Number	:

Authorized Official
Title or Position	:	OWNER, DOCTOR
Name	:	TIM LEUNG
Credential	:	D.C, M.S.
Telephone Number	:	303-692-8803

Provider Enumeration Date	:	12/14/2007
Last Update Date	:	12/14/2007

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Directions to “BACK 2 LIFE HEALTH CENTER ” Practice Location

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