NPI | 1609535145 |
---|---|
Doing Business As | BACK TO LIFE |
Entity Type | Organization |
Authorized Contact | PATRICK GOVINDA MANESS Owner/Provider 561-802-8074 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
Enumeration Date | 2021-12-13 |
Last Update Date | 2021-12-13 |