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General NPI Number Information
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NPI Number | 1073162871
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Entity Type | Organization
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Legal Business Name | 608 CHIROPRACTIC PC
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 412 WEST AVE
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City | HOLDREGE
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State | NE
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Zip | 68949-2223
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Country | US
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Telephone | 308-995-2355
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Fax | 308-995-2349
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Provider Business Mailing Address
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Address Line | 412 WEST AVE
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City | HOLDREGE
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State | NE
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Zip | 68949-2223
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Country | US
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Telephone | 308-995-2355
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Fax | 308-995-2349
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Authorized Official
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Title or Position | DOCTOR
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Name | TARA ESSINGTON
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Credential |
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Telephone | 308-991-6601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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