Organization
BACK TO NORMAL II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN K CZERWEIN JR. MD (MANAGER)
(800) 310-7334
Entity
Organization
Contact information
Practice address
53 SADDLE ROWE LN, NORTH SCITUATE, RI 02857-1271
(401) 749-0539
Mailing address
DEPT # 880237 PO BOX 29650, PHOENIX, AZ 85038-9650
(800) 310-7334
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
MD12647
RI
Other
Enumeration date
10/17/2017
Last updated
10/08/2018
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