MEDICARE: BACK ISSUES PC INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902892888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACK ISSUES PC INC

Provider Business Mailing Address
First Line	:	378 S MAIN ST
Second Line	:
City	:	PATASKALA
State	:	OH
Zip	:	43062-8392
Country	:	US
Telephone Number	:	740-964-2081
Fax Number	:	614-656-4027

Provider Business Practice Location Address
First Line	:	378 S MAIN ST
Second Line	:
City	:	PATASKALA
State	:	OH
Zip	:	43062-8392
Country	:	US
Telephone Number	:	740-964-2081
Fax Number	:	614-656-4027

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEFFREY ADAM KORN
Credential	:	DC
Telephone Number	:	740-964-2081

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	08/22/2020

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Directions to “BACK ISSUES PC INC ” Practice Location

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