Organization
TUCKER NECK AND BACK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY L BANGUILAN D.C. (CEO)
(770) 621-5585
Entity
Organization
Contact information
Practice address
4880 LAWRENCEVILLE HWY, SUITE 13, TUCKER, GA 30084-2938
(770) 621-5585
(770) 414-7355
Mailing address
4880 LAWRENCEVILLE HWY, SUITE 13, TUCKER, GA 30084-2938
(770) 621-5585
(770) 414-7355
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR0006452
GA
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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