Back to Back Chiropractic LTD
Organization Active NPI Chiropractor · Moline, IL
NPI 1619984804 · NPPES record last updated Oct 25, 2024
Key facts
- NPI
- 1619984804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 038009599 (IL)
- Legal business name
- BACK TO BACK CHIROPRACTIC LTD
- Practice address
- 1825 Avenue of the Cities
Moline, IL 61265-4859 - Phone
- (309) 797-6200
- Fax
- (309) 797-6201
- NPI assigned
- Aug 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Patricia Marie Miller, D.C.
- Title
- Chiropractor
- Phone
- (309) 797-6200
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110224000044 | IL | Part B Supplier - Clinic/Group Practice | 9032390034 |
Receives reassigned benefits from 1 practitioner Practice locations: Moline, IL |
National Provider Directory
Locations
1825 Avenue of the Cities
Moline, IL 61265
Phone (309) 797-5789
3637 Avenue of the Cities
Ste 205
Moline, IL 61265
Phone (309) 797-6200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 038009599 | IL | Yes |
Addresses
Primary practice location
1825 Avenue of the Cities
Moline, IL 61265-4859
Mailing address
1825 Avenue of the Cities
Moline, IL 61265-4859
Phone (309) 797-6200
Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.