Healthcare Provider Details
I. General information
NPI: 1619399375
Provider Name (Legal Business Name): FINISH LINE CHIROPRACTIC & ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2014
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
403 E HYNES AVE
ONEILL NE
68763-1301
US
IV. Provider business mailing address
403 E HYNES AVE
ONEILL NE
68763-1301
US
V. Phone/Fax
- Phone: 402-336-9979
- Fax:
- Phone: 402-336-9979
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 1785 |
| License Number State | NE |
VIII. Authorized Official
Name:
DANIEL
WAYNE
NEKOLITE
Title or Position: OWNER
Credential:
Phone: 402-336-9979