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NPI Code Detail

MEDICARE: BACK 2 BACK CHIROPRACTIC CANTON LLC

MEDICARE: BACK 2 BACK CHIROPRACTIC CANTON 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
1111NN0400XNeurology Chiropractor
2111NP0017XPediatric Chiropractor
3111NN1001XNutrition Chiropractor
4111NS0005XSports Physician Chiropractor
5111NX0800XOrthopedic Chiropractor
6111N00000XChiropractor

General Provider Information

NPI Number : 1871389650
Entity Type Code : Organization
Provider Name (Legal Business Name) : BACK 2 BACK CHIROPRACTIC CANTON LLC
Provider Business Mailing Address
First Line : 3422 SIXES RD STE 110
Second Line :
City : CANTON
State : GA
Zip : 30114-9120
Country : US
Telephone Number : 715-862-2423
Fax Number :
Provider Business Practice Location Address
First Line : 3422 SIXES RD STE 110
Second Line :
City : CANTON
State : GA
Zip : 30114-9120
Country : US
Telephone Number : 715-862-2423
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. STEVEN WALLIN
Credential : DC
Telephone Number : 715-862-2423
Provider Enumeration Date : 04/17/2025
Last Update Date : 04/17/2025

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Directions to “BACK 2 BACK CHIROPRACTIC CANTON LLC ” Practice Location

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