Back to Life

Primary specialty

Radiology ChiropractorTaxonomy code 111NR0200X

License

CHIR007378 Issued in GA

Legal business name

BACK TO LIFE

Doing business as

promonencechiropractic

Practice address

110 Prominence Point Pkwy Ste 122
Canton, GA 30114-9076

Phone

(770) 345-4520

Fax

(770) 345-4524

NPI assigned

Apr 18, 2007

Last updated

Dec 4, 2007By 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. Eric Anthony Cavaciuti, D.C.NPI 1407974538

Title

Ower

Phone

(770) 345-4520

Specialties & licenses 1

Addresses

Other names 1

• promonencechiropractic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric Anthony Cavaciuti, DC

  • Chiropractor
  • Canton, GA
  • NPI 1407974538
  NPD (past) Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1447476445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PROMINENCE POINT PKWY STE 122",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149076",
            "telephone_number": "770-345-4520",
            "fax_number": "770-345-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PROMINENCE POINT PKWY STE 122",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149076",
            "telephone_number": "770-345-4520",
            "fax_number": "770-345-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "CAVACIUTI",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWER",
        "authorized_official_telephone_number": "770-345-4520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "GA",
            "license": "CHIR007378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "promonencechiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amal Azar, PHARMD
• Gordon Jerome Azar Jr., M.D., F.A.C.C.
• Nader Baaklini
• Jennifer Bacchus, PHARMD
• Back 2 Back Chiropractic Canton LLC (Back 2 Back Chiropractic)
• Back to Life Medical Group, LLC (Georgia Pain Treatment Centers)
• Back to Life Medical Group, LLC (Spinal Medical Centers)
• Adam Davis Bagley, LMFT
• Robert Bagwell Jr., PHARMD
• Priscilla Di Bailey

• Radiology Chiropractor in Canton, GA
• Providers in Canton, GA by specialty
• Radiology Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.