Provider Demographics
NPI:1205292315
Name:ADVANCED BACK AND NECK, LLC
Entity type:Organization
Organization Name:ADVANCED BACK AND NECK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-299-5700
Mailing Address - Street 1:1055 W QUEEN CREEK RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-8134
Mailing Address - Country:US
Mailing Address - Phone:480-814-7115
Mailing Address - Fax:480-814-7792
Practice Address - Street 1:1055 W QUEEN CREEK RD STE 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-8134
Practice Address - Country:US
Practice Address - Phone:480-814-7115
Practice Address - Fax:480-814-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32912208VP0014X
AZ8894225100000X
AZ8194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ185706Medicare PIN