Provider Demographics
NPI:1316731284
Name:NECK AND BACK CENTER OF ERIE, LLC
Entity type:Organization
Organization Name:NECK AND BACK CENTER OF ERIE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-897-4047
Mailing Address - Street 1:1408 AMBER DAY DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5733
Mailing Address - Country:US
Mailing Address - Phone:512-897-4047
Mailing Address - Fax:
Practice Address - Street 1:3441 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2794
Practice Address - Country:US
Practice Address - Phone:814-864-2225
Practice Address - Fax:814-868-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty