Organization Name: | BACK IN MOTION CLINIC OF CHIROPRACTIC |
NPI Number: | 1346571338 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLES GEORGE GOLDIZEN (PRESIDENT) |
Mailing Address: | 703 Fairview St Fountain Inn |
State: | SC US |
Postal Code: | 296441541 |
Phone Number: | 8646019012 |
Fax Number: | |
NPI Enumeration Date: | 01/15/2010 |
NPI Last Update Date: | 01/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 3498 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |