Provider Demographics
NPI:1154766103
Name:BACK ON TRACK FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BACK ON TRACK FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIOPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:BAGGALEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-504-6125
Mailing Address - Street 1:800 N 100 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-5577
Mailing Address - Country:US
Mailing Address - Phone:801-504-6125
Mailing Address - Fax:385-200-1425
Practice Address - Street 1:800 N 100 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-5577
Practice Address - Country:US
Practice Address - Phone:801-504-6125
Practice Address - Fax:385-200-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4920883-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty