Provider Demographics
NPI:1942499876
Name:I GOT YOUR BACK CHIROPRACTIC INC
Entity type:Organization
Organization Name:I GOT YOUR BACK CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:HUDAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-468-9990
Mailing Address - Street 1:8359 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-2041
Mailing Address - Country:US
Mailing Address - Phone:816-468-9990
Mailing Address - Fax:816-468-9992
Practice Address - Street 1:8359 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-2041
Practice Address - Country:US
Practice Address - Phone:816-468-9990
Practice Address - Fax:816-468-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999135672111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty