Organization
THE BACK SHAK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE CAUSEY (OWNER)
(843) 267-0560
Entity
Organization
Contact information
Practice address
223 FRESH DR UNIT B, MYRTLE BEACH, SC 29579-4462
(843) 903-5772
(843) 492-4020
Mailing address
777 DRAGONFLY DR, MYRTLE BEACH, SC 29579-5263
(843) 267-0560
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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