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General NPI Number Information
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NPI Number | 1609084367
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Entity Type | Organization
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Legal Business Name | MCCRACKEN CHIROPRACTIC CLINIC, INC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 5740 OLD CHENEY RD SUITE 16
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City | LINCOLN
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State | NE
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Zip | 68516-3544
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Country | US
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Telephone | 402-421-2277
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Fax | 402-421-7386
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Provider Business Mailing Address
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Address Line | 5740 OLD CHENEY RD SUITE 16
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City | LINCOLN
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State | NE
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Zip | 68516-3544
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Country | US
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Telephone | 402-421-2277
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Fax | 402-421-7386
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | HEIDI L CHENEY
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Credential |
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Telephone | 402-421-2277
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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 | 658
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License Number State | NE
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