Organization
DECATUR NECK AND BACK
Active
Other names
Georgia Neck and Back
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY BANGUILAN D.C. (OFFICE MANAGER)
(770) 963-5585
Entity
Organization
Contact information
Practice address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Mailing address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
CHIR006452
GA
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR008031
GA
207Q00000X
Family Medicine Physician
016356
GA
Other
Enumeration date
06/21/2007
Last updated
09/11/2025
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