# BACK ON TRACK CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366612400
- **Authorized official:** DR. KENNETH A ILES DC (CHIROPRACTOR/MEMBER)
- **Authorized official phone:** (315) 699-9887

## Contact information

- **Practice address:** 8129 BREWERTON RD, CICERO, NY 13039
- **Practice address phone:** (315) 699-9887
- **Mailing address:** 8129 BREWERTON RD, CICERO, NY 13039
- **Mailing address phone:** (315) 699-9887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009391 | NY | Yes |

## Other

- **Enumeration date:** 03/05/2008
- **Last updated:** 01/10/2012