=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407632862
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILFORD CHIROPRACTIC L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2023
-----------------------------------------------------
Last Update Date | 09/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 508 1ST ST
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68405-9701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-761-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 508 1ST ST
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68405-9701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-761-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIROPRACTIC
-----------------------------------------------------
Name | DR. JORDON SCOTT FOLKERS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 308-529-1492
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------