Healthcare Provider Details

I. General information

NPI: 1902373822
Provider Name (Legal Business Name): BEYOND THE SPINE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 N 7TH ST
PLATTSMOUTH NE
68048-1310
US

IV. Provider business mailing address

306 N 7TH ST
PLATTSMOUTH NE
68048-1310
US

V. Phone/Fax

Practice location:
  • Phone: 402-298-5774
  • Fax: 402-999-0871
Mailing address:
  • Phone: 402-298-5774
  • Fax: 402-999-0871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY M BRADLEY
Title or Position: OWNER
Credential: DC
Phone: 402-881-9638