Provider Demographics
NPI:1295187755
Name:THE BACK AND NECK PAIN CENTER OF MONTEREY - GAILY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:THE BACK AND NECK PAIN CENTER OF MONTEREY - GAILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAILY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:831-521-7993
Mailing Address - Street 1:1299 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6144
Mailing Address - Country:US
Mailing Address - Phone:831-657-0191
Mailing Address - Fax:831-657-0192
Practice Address - Street 1:1299 PACIFIC ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6144
Practice Address - Country:US
Practice Address - Phone:831-657-0191
Practice Address - Fax:831-657-0192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC028950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU97873Medicare UPIN
CADC0289500Medicare PIN