Back in Motion Spinal Clinic,Inc

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

CH0007076 Issued in FL

Legal business name

BACK IN MOTION SPINAL CLINIC,INC

Practice address

2704 N University Dr
Sunrise, FL 33322-2435

Phone

(954) 748-1004

NPI assigned

Apr 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bryan Harris Kalodish, DC

Title

Owner

Phone

(954) 748-1004

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336366400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 N UNIVERSITY DR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333222435",
            "telephone_number": "954-748-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N UNIVERSITY DR",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333222435",
            "telephone_number": "954-748-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION SPINAL CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KALODISH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-748-1004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "FL",
            "license": "CH0007076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.