Healthcare Provider Details

I. General information

NPI: 1497032049
Provider Name (Legal Business Name): CHASE DEAN L'HEUREUX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W 29TH ST SUITE A
KEARNEY NE
68845-3473
US

IV. Provider business mailing address

6909 S 157TH ST STE G
OMAHA NE
68136-3052
US

V. Phone/Fax

Practice location:
  • Phone: 308-234-6900
  • Fax:
Mailing address:
  • Phone: 402-905-0132
  • Fax: 402-506-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1694
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: