Organization
BACK AND NECK PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAPHET DIVAD LEGRANT DC (OWNER)
(276) 632-3334
Entity
Organization
Contact information
Practice address
1141 MEMORIAL BLVD N, MARTINSVILLE, VA 24112-2429
(276) 632-3334
(276) 632-1882
Mailing address
1141 MEMORIAL BLVD N, MARTINSVILLE, VA 24112-2429
(276) 632-3334
(276) 632-1882
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/30/2019
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