Healthcare Provider Details

I. General information

NPI: 1609169143
Provider Name (Legal Business Name): OLBERDING FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 05/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E 16TH ST
FALLS CITY NE
68355-2605
US

IV. Provider business mailing address

1121 FULTON ST
FALLS CITY NE
68355-3035
US

V. Phone/Fax

Practice location:
  • Phone: 402-801-1225
  • Fax:
Mailing address:
  • Phone: 402-801-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1669
License Number StateNE

VIII. Authorized Official

Name: DR. MISTY OLBERDING
Title or Position: MANAGER
Credential: D.C.
Phone: 402-801-1225