# BACK & NECK CARE CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205237559
- **Authorized official:** DR. DAVID BOWDEN II D.C. (OWNER)
- **Authorized official phone:** (618) 566-3005

## Contact information

- **Practice address:** 410 E MAIN ST, MASCOUTAH, IL 62258-2229
- **Practice address phone:** (618) 566-3005
- **Practice address fax:** (618) 551-2777
- **Mailing address:** 410 E MAIN ST, MASCOUTAH, IL 62258-2229
- **Mailing address phone:** (618) 566-3005
- **Mailing address fax:** (618) 551-2777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 038012578 | IL | Yes |

## Other

- **Enumeration date:** 09/05/2014
- **Last updated:** 10/01/2015