Provider Demographics
NPI:1891556080
Name:NECK & BACK PAIN RELIEF LLC
Entity Type:Organization
Organization Name:NECK & BACK PAIN RELIEF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:T
Authorized Official - Last Name:REAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-871-0616
Mailing Address - Street 1:220 HARTFORD TPKE STE 3
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4700
Mailing Address - Country:US
Mailing Address - Phone:860-871-0616
Mailing Address - Fax:
Practice Address - Street 1:220 HARTFORD TPKE STE 3
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4700
Practice Address - Country:US
Practice Address - Phone:860-871-0616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty