Healthcare Provider Details

I. General information

NPI: 1750802203
Provider Name (Legal Business Name): CORNERSTONE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2295 S 48TH ST
LINCOLN NE
68506-5536
US

IV. Provider business mailing address

4747 PIONEERS BLVD STE 600
LINCOLN NE
68506-5332
US

V. Phone/Fax

Practice location:
  • Phone: 402-843-6910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1839
License Number StateNE

VIII. Authorized Official

Name: DR. DEREK ALAN SCHOLL
Title or Position: OWNER & PRESIDENT
Credential: D.C.
Phone: 402-843-6910