| Advanced Back Center | |
|
200 Queen St, Southington, CT 06489-1901 | |
| (860) 621-2225 | |
| (860) 621-2868 |
| Full Name | Advanced Back Center |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 200 Queen St, Southington, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043486947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 000938 (Connecticut) | Primary |
| Provider Name | James Davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568716926 PECOS PAC ID: 4789585902 Enrollment ID: I20040120000226 |
| Provider Name | Michael A Naccarella |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124112370 PECOS PAC ID: 7113026592 Enrollment ID: I20070626000390 |
| Provider Name | Stacey K Raya |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1073502134 PECOS PAC ID: 5193858231 Enrollment ID: I20100727000303 |
| Provider Name | Jeana N Forant |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093017527 PECOS PAC ID: 0042496325 Enrollment ID: I20110523000043 |
| Provider Name | Marcus P Yancoskie |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1174603146 PECOS PAC ID: 2769649466 Enrollment ID: I20120208000532 |
| Provider Name | Renee A Brown |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356775332 PECOS PAC ID: 4183849342 Enrollment ID: I20140701001343 |
| Provider Name | Jason Thomas Stryjewski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1114279288 PECOS PAC ID: 5294958419 Enrollment ID: I20140922000060 |
| Provider Name | Saxon Ireland |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790306694 PECOS PAC ID: 8224457452 Enrollment ID: I20210601000149 |
| Provider Name | Austin Lawrence |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912633231 PECOS PAC ID: 3476938481 Enrollment ID: I20220912001991 |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Back Center 200 Queen St, Southington, CT 06489-1901 Ph: (860) 621-2225 | Advanced Back Center 200 Queen St, Southington, CT 06489-1901 Ph: (860) 621-2225 |
Dr. Stacey Kim Raya, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 200 Queen St, Southington, CT 06489 Phone: 860-621-2225 Fax: 860-621-2868 | |
Dr. Jeana Forant, DC Chiropractor Medicare: May Accept Medicare Assignments Practice Location: 200 Queen St, Southington, CT 06489 Phone: 860-621-2225 | |
Dr. Koby Douglas Fowler, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1095 West St Unit 1, Southington, CT 06489 Phone: 860-620-1705 Fax: 860-620-1746 | |
Life Family Chiropractic Of Southington, Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 56 Center St Ste 2, Southington, CT 06489 Phone: 860-276-9970 | |
Southington Chiropractic Center, P.c. Chiropractor Medicare: Medicare Enrolled Practice Location: 474 N Main St, Southington, CT 06489 Phone: 860-621-7770 Fax: 860-621-2782 | |
Dr. Donald F Salomone, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 474 N Main St, Southington, CT 06489 Phone: 860-621-7770 Fax: 860-621-2782 |