Organization
BACK PAIN SOLUTIONS INC.
Active
Other names
Jay Kennedy DC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY MICHAEL KENNNEDY D.C. (OWNER/PRESIDENT)
(814) 267-5830
Entity
Organization
Contact information
Practice address
808 DIAMOND ST, BERLIN, PA 15530-1539
(181) 426-7830
Mailing address
808 DIAMOND ST, BERLIN, PA 15530-1539
(181) 426-7830
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
DC003949L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01162738
—
PA
01
—
1508429
GATEWAY
PA
01
—
2058294
AETNA HMO/POS
PA
01
—
216978
UPMC
PA
01
—
4281751
AETNA PPO/POS
PA
Enumeration date
02/13/2008
Last updated
02/13/2008
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