| NPI | 1053186536 |
|---|---|
| Doing Business As | BACKROADS ENDURANCE COMPANY |
| Entity Type | Organization |
| Authorized Contact | BLAKE DIRCKSEN Owner 317-385-8525 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |