Provider Demographics
NPI:1518259241
Name:FAMILY BACK & NECK CARE CENTER, INC
Entity Type:Organization
Organization Name:FAMILY BACK & NECK CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-548-9079
Mailing Address - Street 1:19110 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3702
Mailing Address - Country:US
Mailing Address - Phone:301-548-9079
Mailing Address - Fax:
Practice Address - Street 1:19110 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-3702
Practice Address - Country:US
Practice Address - Phone:301-548-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01513111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty