Organization
BACK TO HEALTH CHIROPRACTIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER ANN CLUCK D.C. (PRESIDENT)
(785) 989-4644
Entity
Organization
Contact information
Practice address
324 SAINT JOSEPH ST, WATHENA, KS 66090-1280
(785) 989-4644
(785) 989-4660
Mailing address
PO BOX 100, WATHENA, KS 66090-0100
(785) 989-4644
(785) 989-4660
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
K01-04749
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060911
INDIVIDUAL MEDICARE PIN
KS
Enumeration date
05/22/2006
Last updated
07/26/2010
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