Healthcare Provider Details
I. General information
NPI: 1790485027
Provider Name (Legal Business Name): ERIN O'GARA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4130 PIONEER WOODS DRIVE ATTN: DR. ERIN O'GARA
LINCOLN NE
68506
US
IV. Provider business mailing address
4130 PIONEER WOODS DR #3
LINCOLN NE
68506
US
V. Phone/Fax
- Phone: 402-261-6841
- Fax: 402-261-6843
- Phone: 402-261-6841
- Fax: 402-261-6843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2159 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: