Organization
BACK ON TRACK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LEE KILLEN D.C. (PRESIDENT)
(985) 735-1112
Entity
Organization
Contact information
Practice address
528 AVENUE F, BOGALUSA, LA 70427-3636
(985) 735-1112
(985) 735-1386
Mailing address
528 AVENUE F, BOGALUSA, LA 70427-3636
(985) 735-1112
(985) 735-1386
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1416
LA
207R00000X
Internal Medicine Physician
Primary
MD009648
LA
332B00000X
Durable Medical Equipment & Medical Supplies
—
LA
Other
Enumeration date
11/10/2007
Last updated
01/23/2012
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