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General NPI Number Information
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NPI Number | 1295486587
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Entity Type | Organization
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Legal Business Name | SUBLUXATION 3, LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2457 33RD AVE
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City | COLUMBUS
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State | NE
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Zip | 68601-1309
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Country | US
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Telephone | 24-265-6800
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Fax | 308-384-7088
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Provider Business Mailing Address
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Address Line | 2441 N DIERS AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-1240
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Country | US
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Telephone | 308-384-4955
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Fax | 308-384-7088
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT P RIEF
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Credential | DC
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Telephone | 308-384-4955
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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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