Organization
BACK BAY HEALTH LLC
Active
Other names
Back Bay Health and Performance, Mass Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY RICHARD LATHAM DC (OWNER)
(724) 554-2795
Entity
Organization
Contact information
Practice address
665 BOYLSTON ST # 3, BOSTON, MA 02116-4824
(724) 554-2795
(857) 350-3251
Mailing address
665 BOYLSTON ST # 3, BOSTON, MA 02116-4824
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/07/2013
Last updated
08/08/2020
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