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General NPI Number Information
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NPI Number | 1831428366
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Entity Type | Organization
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Legal Business Name | NECK AND BACK PAIN INSTITUTE, INC
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 10251 W SAMPLE ROAD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065
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Country | US
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Telephone | 954-575-4045
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Fax | 954-575-5983
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Provider Business Mailing Address
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Address Line | 10251 W SAMPLE ROAD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065
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Country | US
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Telephone | 954-575-4045
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Fax | 954-575-5983
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID B BASS
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Credential | DC
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Telephone | 954-575-4045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CH3178
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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