Healthcare Provider Details
I. General information
NPI: 1861631905
Provider Name (Legal Business Name): YORK CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2009
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 S 9TH ST
LINCOLN NE
68508-2216
US
IV. Provider business mailing address
321 S 9TH ST
LINCOLN NE
68508-2216
US
V. Phone/Fax
- Phone: 402-261-8974
- Fax:
- Phone: 402-261-8974
- Fax: 402-261-8976
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1362 |
| License Number State | NE |
VIII. Authorized Official
Name:
CARRIE
ANN
YORK
Title or Position: OWNER/PRESIDENT
Credential: D.C.
Phone: 402-261-8974