Provider Demographics
NPI:1932394608
Name:ALLIANCE BACK & NECK CARE INC.
Entity type:Organization
Organization Name:ALLIANCE BACK & NECK CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CONNORS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-852-8400
Mailing Address - Street 1:973 QUAIL RDG
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2926
Mailing Address - Country:US
Mailing Address - Phone:817-852-8400
Mailing Address - Fax:817-428-4436
Practice Address - Street 1:2401 WESTPORT PARKWAY
Practice Address - Street 2:STE. 1300
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-2926
Practice Address - Country:US
Practice Address - Phone:817-852-8400
Practice Address - Fax:817-428-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU63456Medicare UPIN