Healthcare Provider Details

I. General information

NPI: 1710217740
Provider Name (Legal Business Name): GENTZLER CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 S 70TH ST STE 110
LINCOLN NE
68516-6711
US

IV. Provider business mailing address

4400 S 70TH ST STE 110
LINCOLN NE
68516-6711
US

V. Phone/Fax

Practice location:
  • Phone: 402-261-6841
  • Fax: 402-261-6843
Mailing address:
  • Phone: 402-261-6841
  • Fax: 402-261-6843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1607
License Number StateNE

VIII. Authorized Official

Name: DR. ADAM C GENTZLER
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 402-261-6841