Back to Life Chiropractic, LLC

Organization Active NPI Chiropractor · Commerce, GA

NPI 1700312733 · NPPES record last updated Dec 19, 2019

Key facts

NPI
1700312733
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
License
CHIR009368 (GA)
Legal business name
BACK TO LIFE CHIROPRACTIC, LLC
Practice address
37 State St
Commerce, GA 30529-1920
Phone
(706) 944-3472
NPI assigned
May 11, 2017
Organization subpart
No

Authorized official

Name
Donn Mitchell Blencowe, D.C.
Title
Owner/Sole Proprietor
Phone
(770) 833-2860

National Provider Directory

Locations

37 State St
Commerce, GA 30529
Phone (706) 944-3472

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X CHIR009368 GA Yes

Addresses

Primary practice location

37 State St
Commerce, GA 30529-1920

Mailing address

37 State St
Commerce, GA 30529-1920
Phone (706) 944-3472

Other providers in Commerce, GA

All providers in Commerce, GA · Chiropractor in Georgia

Sources for this page

Verify at the official NPI Registry.