Organization
BACK TO HEALTH CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BANASIAK D.C. (DR OF CHIROPRACTIC)
(951) 587-2225
Entity
Organization
Contact information
Practice address
27450 YNEZ RD, 116, TEMECULA, CA 92591-4649
(951) 587-2225
(951) 587-2220
Mailing address
27450 YNEZ RD, 116, TEMECULA, CA 92591
(951) 587-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC23625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0236250
BLUE SHIELD
CA
Enumeration date
10/17/2006
Last updated
02/08/2010
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