Organization
BACK TO LIFE CHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JEROME KOC III D.C. (OWNER)
(480) 703-1834
Entity
Organization
Contact information
Practice address
4045 E BELL RD, STE 107, PHOENIX, AZ 85032-2236
(480) 703-1834
(602) 493-2399
Mailing address
4045 E BELL RD, STE 107, PHOENIX, AZ 85032-2236
(480) 703-1834
(602) 493-2399
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6076
AZ
Other
Enumeration date
03/07/2008
Last updated
06/11/2013
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