| Organization Name: | BACK SPECIALISTS OF THE MIDWEST LLC |
| NPI Number: | 1346345840 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRUCE JON HAGEN (OWNER) |
| Mailing Address: | 5109 S Crossing Pl Ste 1 Sioux Falls |
| State: | SD US |
| Postal Code: | 571085076 |
| Phone Number: | 6053611700 |
| Fax Number: | 6053610113 |
| NPI Enumeration Date: | 09/13/2006 |
| NPI Last Update Date: | 09/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1351 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |