Organization
ADVANCED BACK CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY KIM RAYA D.C. (OWNER/PRESIDENT)
(860) 621-2225
Entity
Organization
Contact information
Practice address
200 QUEEN ST, SOUTHINGTON, CT 06489-1901
(860) 621-2225
(860) 621-2868
Mailing address
200 QUEEN ST, SOUTHINGTON, CT 06489-1901
(860) 621-2225
(860) 621-2868
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
000938
CT
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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