Provider Demographics
NPI:1407284631
Name:NECK AND BACK INJURY CLINIC, LLC
Entity Type:Organization
Organization Name:NECK AND BACK INJURY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-494-0370
Mailing Address - Street 1:5835 CAMPBELLTON RD SW
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8013
Mailing Address - Country:US
Mailing Address - Phone:404-494-0370
Mailing Address - Fax:404-393-0691
Practice Address - Street 1:1287 SPUR HIGHWAY 138
Practice Address - Street 2:SUITE 10
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236
Practice Address - Country:US
Practice Address - Phone:404-494-0370
Practice Address - Fax:404-393-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty