Organization
BACK TO LIFE CHIROPRACTIC L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P. GANO D.C. (OPERATOR/CHIROPRACTOR)
(219) 728-6649
Entity
Organization
Contact information
Practice address
761 INDIAN BOUNDARY RD, SUITE 4, CHESTERTON, IN 46304-1586
(219) 728-6649
(888) 741-5926
Mailing address
761 INDIAN BOUNDARY RD, SUITE 4, CHESTERTON, IN 46304-1586
(219) 728-6649
(888) 741-5926
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002566A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201358400 A
—
IN
Enumeration date
04/22/2016
Last updated
09/01/2016
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