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Organization
BACK AND NECK PAIN CLINIC, LLC
Active
Organization
BACK AND NECK PAIN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DAVIS (ACCOUNTS MANAGER)
(850) 866-3250
Entity
Organization
Contact information
Practice address
321 WESTGATE PKWY STE 1, DOTHAN, AL 36303-3072
(850) 702-0898
Mailing address
321 WESTGATE PKWY STE 1, DOTHAN, AL 36303-3072
(850) 702-0898
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I511
MEDICARE GROUP NUMBER
AL
Enumeration date
01/18/2008
Last updated
01/18/2008
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