Back In Action Holistic Health Center
Chiropractor in Rockford, IL. Organization (NPI-2).
NPI number1063554343
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1063554343
- Entity type
- Organization (NPI-2)
- Legal business name
- Back In Action Holistic Health Center
- Organization subpart
- No
- Enumeration date
- Feb 13, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
5301 E State StSuite 101
Rockford, IL 61108
Phone 815-397-8500 · Fax 815-397-8588
Mailing address
5301 E State StSuite 101
Rockford, IL 61108
Phone 815-397-8500 · Fax 815-397-8588
Authorized official
Shelly R Vandervort
Office Manager
8153978500
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