Organization
ACTIVE BACK PAIN RELIEF CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER E JOHNSEN DC (MEMBER)
(413) 737-7787
Entity
Organization
Contact information
Practice address
82 MAIN STREET, SUITE 8, WEST SPRINGFIELD, MA 01089
(413) 737-7787
(413) 737-7789
Mailing address
82 MAIN STREET, SUITE 8, WEST SPRINGFIELD, MA 01089
(413) 737-7787
(413) 737-7789
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1917
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y39217
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/29/2007
Last updated
08/22/2020
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