Advanced Back Center

NPI 1043486947 - Chiropractor - 111N00000X

NPI Details
NPI 1043486947
Enumeration Date 05/01/2008
Last Updated 05/01/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name STACEY KIM STACEY
Position OWNER/PRESIDENT
Phone (860) 621-2225
Fax (860) 621-2868
Practice Location
200 QUEEN ST
SOUTHINGTON CT, 06489-1901, US
Phone (860) 621-2225
Fax (860) 621-2868
Business Location
200 QUEEN ST
SOUTHINGTON CT, 06489-1901, US
Phone (860) 621-2225
Fax (860) 621-2868
Toxanomy
Taxonomy Code 111N00000X
License State Connecticut
License Number 000938
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According to our database, Advanced Back Center NPI is 1043486947, taxonomy code is 111N00000X and license number is 000938, license state is located at Connecticut. Advanced Back Center physically located at 200 Queen St, Southington CT, 06489-1901. NPI Number 1033115704 has the healthcare provider type.

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1043486947 NPI number is provided on an as is basis without warranty of any kind. 1043486947 is maintained by the National Plan & Provider Enumeration System. The contents of Advanced Back Center are for informational purposes only.