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General NPI Number Information
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NPI Number | 1356472286
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Entity Type | Organization
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Legal Business Name | HEARTLAND FAMILY HEALTH & CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 1715 N BELL ST OPTIONAL
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City | FREMONT
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State | NE
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Zip | 68025-3158
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Country | US
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Telephone | 402-721-1060
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Fax | 402-727-4761
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Provider Business Mailing Address
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Address Line | 1861 E 23RD ST
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City | FREMONT
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State | NE
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Zip | 68025-2437
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Country | US
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Telephone | 402-721-1060
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Fax | 402-727-4761
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RANDY J CAMENZIND
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Credential | D.C.
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Telephone | 402-721-1060
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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 | 1063
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1023
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License Number State | NE
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