Provider Demographics
NPI:1447930862
Name:BACK AND BODY MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:BACK AND BODY MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOKRATIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:DRAGONAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-233-4200
Mailing Address - Street 1:505 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2190
Mailing Address - Country:US
Mailing Address - Phone:908-233-4200
Mailing Address - Fax:908-233-9020
Practice Address - Street 1:505 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2190
Practice Address - Country:US
Practice Address - Phone:908-233-4200
Practice Address - Fax:908-233-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty