Provider Demographics
NPI:1023107133
Name:BACK 2 HEALTH WELLNESS CENTER
Entity type:Organization
Organization Name:BACK 2 HEALTH WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-514-0333
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NC
Mailing Address - Zip Code:28519-0005
Mailing Address - Country:US
Mailing Address - Phone:252-514-0333
Mailing Address - Fax:252-514-0332
Practice Address - Street 1:1110 C STREET
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NC
Practice Address - Zip Code:28560
Practice Address - Country:US
Practice Address - Phone:252-514-0333
Practice Address - Fax:252-514-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty