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Organization

BACK TO LIFE HEALTH & WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MIA D FRAILS DC (OWNER)
(615) 720-3265
Entity
Organization

Contact information

Practice address
1916 PATTERSON ST, SUITE 310, NASHVILLE, TN 37203-2120
(615) 720-3265
Mailing address
5543 EDMONDSON PIKE, 195, NASHVILLE, TN 37211-5808
(615) 720-3265
(615) 834-2662

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2064
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3973824
TN
Enumeration date
05/22/2012
Last updated
05/22/2012
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