MEDICARE: HINZE CHIROPRACTIC CENTER P C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	974	NE

General Provider Information

NPI Number	:	1619163508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HINZE CHIROPRACTIC CENTER P C

Provider Business Mailing Address
First Line	:	528 N 4TH ST
Second Line	:
City	:	DAVID CITY
State	:	NE
Zip	:	68632-1624
Country	:	US
Telephone Number	:	402-367-6061
Fax Number	:	402-367-4220

Provider Business Practice Location Address
First Line	:	528 N 4TH ST
Second Line	:
City	:	DAVID CITY
State	:	NE
Zip	:	68632-1624
Country	:	US
Telephone Number	:	402-367-6061
Fax Number	:	402-367-4220

Authorized Official
Title or Position	:	MANAGING DOCTOR
Name	:	DR. RUSSELL GENE HELLER
Credential	:	D.C.
Telephone Number	:	402-367-6061

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	06/12/2008

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