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General NPI Number Information
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NPI Number | 1154912780
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Entity Type | Organization
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Legal Business Name | NEBRASKA MOTION CHIROPRACTIC AND REHABILITATION, LLC
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 1220 ARIES DR
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City | LINCOLN
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State | NE
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Zip | 68512-9632
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Country | US
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Telephone | 402-413-9943
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Fax |
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Provider Business Mailing Address
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Address Line | 1220 ARIES DR
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City | LINCOLN
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State | NE
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Zip | 68512-9632
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Country | US
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Telephone | 402-413-9943
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NOLAN H DETHLEFS
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Credential | DC
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Telephone | 308-750-0640
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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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