Organization
BACK TO HEALTH CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS RYAN SCHULTZ DC (OWNER)
(208) 359-2264
Entity
Organization
Contact information
Practice address
60 S 2ND W, REXBURG, ID 83440-1819
(208) 359-2264
Mailing address
60 S 2ND W, REXBURG, ID 83440-1819
(208) 359-2264
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009598
—
ID
Enumeration date
02/11/2020
Last updated
02/11/2020
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