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General NPI Number Information
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NPI Number | 1518259241
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Entity Type | Organization
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Legal Business Name | FAMILY BACK & NECK CARE CENTER, INC
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 19110 MONTGOMERY VILLAGE AVE SUITE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20886-3702
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Country | US
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Telephone | 301-548-9079
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Fax |
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Provider Business Mailing Address
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Address Line | 19110 MONTGOMERY VILLAGE AVE SUITE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20886-3702
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Country | US
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Telephone | 301-548-9079
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MOHAMMAD YOUSEFI
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Credential | D.C.
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Telephone | 301-548-9079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01513
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License Number State | MD
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