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Contact Information

BACK 2 LIFE MEDICAL INC
2016 S EAGLE RD
MERIDIAN, ID83642-6707
 Phone: 208-887-6810
 Fax: 208-887-6797
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for BACK 2 LIFE MEDICAL INC

NPI Number 1033562319
LBN Legal business name BACK 2 LIFE MEDICAL INC
Authorized official JUSTIN GRIFFIN - (OWNER/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/21/2016
Last updated 07/21/2016 - About 10 years ago
Identifiers
ID License # CHIA-874
ID License # NP-1639A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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