Healthcare Provider Details

I. General information

NPI: 1679274112
Provider Name (Legal Business Name): ISAAC OGARA CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 PIONEER WOODS DR STE 3
LINCOLN NE
68506-7552
US

IV. Provider business mailing address

2300 S 80TH ST
LINCOLN NE
68506-3111
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-6841
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ISAAC OGARA
Title or Position: MANAGING MEMBER
Credential:
Phone: 402-987-3320