Healthcare Provider Details

I. General information

NPI: 1417867060
Provider Name (Legal Business Name): CODY CHRISTOPHER ELLIOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 K PLZ
OMAHA NE
68137-2269
US

IV. Provider business mailing address

3485 COUNTY ROAD K
TEKAMAH NE
68061-4139
US

V. Phone/Fax

Practice location:
  • Phone: 531-772-0262
  • Fax:
Mailing address:
  • Phone: 402-838-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2239
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: