Provider Demographics
NPI:1871649376
Name:BACK AND NECK CENTER
Entity Type:Organization
Organization Name:BACK AND NECK CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-264-9612
Mailing Address - Street 1:5667 WILLISTON RD
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-5296
Mailing Address - Country:US
Mailing Address - Phone:802-879-1703
Mailing Address - Fax:
Practice Address - Street 1:5667 WILLISTON RD
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-5296
Practice Address - Country:US
Practice Address - Phone:802-879-1703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVN3127Medicare ID - Type Unspecified