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Organization
ADVANCED BACK & WELLNESS CENTER LLC
Active
Organization
ADVANCED BACK & WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA ANN BURNS DC (CHIROPRACTIC PHYSICIAN)
(860) 928-2292
Entity
Organization
Contact information
Practice address
21 S MAIN ST, PUTNAM, CT 06260-1906
(860) 928-2292
(860) 928-0537
Mailing address
21 S MAIN ST, PUTNAM, CT 06260-1906
(860) 928-2292
(860) 928-0537
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D100146044
MEDICARE GROUP PTAN
CT
Enumeration date
05/21/2014
Last updated
07/15/2020
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