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Organization
DECATUR NECK AND BACK
Active
Organization
DECATUR NECK AND BACK
Active
Other names
Georgia Neck and Back
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY BANGUILAN D.C. (OFFICE MANAGER)
(770) 963-5585
Entity
Organization
Contact information
Practice address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Mailing address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
CHIR006452
GA
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR008031
GA
207Q00000X
Family Medicine Physician
016356
GA
Other
Enumeration date
06/21/2007
Last updated
09/11/2025
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