Provider Demographics
NPI:1366701484
Name:BACK TO HARMONY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:BACK TO HARMONY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-544-2611
Mailing Address - Street 1:241 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:16037-9247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:241 PERRY HWY
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-9247
Practice Address - Country:US
Practice Address - Phone:724-544-2611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022376580001Medicaid
OH2935328Medicaid
OH2935328Medicaid