BACK TO BALANCE CHIROPRACTIC, LLC (NPI# 1851840565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851840565 |
| Entity Type | Organization |
| Organization Name | BACK TO BALANCE CHIROPRACTIC, LLC |
| Practice Address |
110 Packerland Drive Suite B Green Bay WI 54303 |
| Practice Telephone | 9522327246 |
| Mailing Telephone | 9522327246 |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-10-07 |
| Authorized Official Name | KRISTIN L HACKBARTH (CHIROPRACTOR) |
| Authorized Official Telephone | 9522327246 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 4774-012 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1417234790 | 05 |
| Street Address |
110 PACKERLAND DRIVE SUITE B |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| 1063730042 | Bradley C Heraly | Internal Medicine | 1726 Shawano Avenue, Green Bay Oncology, Green Bay, WI 54303 | 2010-05-14 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861916769 | Atlas Spinal Care | Chiropractor | 2069 Central Ct, Suite 11, Green Bay, WI 54311 | 2017-08-01 |
| 1376067413 | Tyler Allen Malueg | Chiropractor | 2069 Central Ct Ste 11, Green Bay, WI 54311-4281 | 2017-07-31 |
| 1982082277 | Matthew Hallam | Chiropractor | 1541 Bellevue St Ste 5, Green Bay, WI 54311-6266 | 2015-05-07 |
| 1861893018 | Leah Hetebrueg | Chiropractor | 2066 Central Dr, Unit D, Green Bay, WI 54311-4244 | 2014-09-08 |
| 1518368836 | Jesse Anderson | Chiropractor | 982 N Taylor St, Green Bay, WI 54303-1202 | 2014-09-05 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1083980981 | Healthy Living Chiropractic Clinic Inc. | Chiropractor | 858 Hansen Rd, Green Bay, WI 54304-5324 | 2012-03-26 |
| 1730409111 | Cornerstone Chiropractic Sc | Chiropractor | 2763 S Oneida St, Green Bay, WI 54304-5750 | 2010-06-08 |
| 1689906240 | Hazuka Spinal Center Inc | Chiropractor | 1742 E Mason St, Green Bay, WI 54302-3259 | 2010-02-08 |
| 1497989677 | Erin Ann Denil | Chiropractor | 1028 9th St, Green Bay, WI 54304-3445 | 2009-05-04 |
| Find all providers in GREEN BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.