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General NPI Number Information
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NPI Number | 1346432242
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Entity Type | Organization
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Legal Business Name | KENNETH L. MAHNKE D.C.,P.A.
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 748 E MILITARY AVE
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City | FREMONT
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State | NE
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Zip | 68025-5183
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Country | US
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Telephone | 402-721-2818
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Fax | 402-721-9481
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Provider Business Mailing Address
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Address Line | 748 E MILITARY AVE
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City | FREMONT
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State | NE
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Zip | 68025-5183
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Country | US
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Telephone | 402-721-2818
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Fax | 402-721-9481
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Authorized Official
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Title or Position | DC/OWNER
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Name | KENNETH L. MAHNKE
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Credential | D.C.,P.A.
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Telephone | 402-721-2818
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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 | 616
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License Number State | NE
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