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General NPI Number Information
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NPI Number | 1609169143
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Entity Type | Organization
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Legal Business Name | OLBERDING FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 216 E 16TH ST
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City | FALLS CITY
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State | NE
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Zip | 68355-2605
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Country | US
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Telephone | 402-801-1225
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 FULTON ST
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City | FALLS CITY
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State | NE
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Zip | 68355-3035
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Country | US
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Telephone | 402-801-1225
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MISTY OLBERDING
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Credential | D.C.
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Telephone | 402-801-1225
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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 | 1669
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License Number State | NE
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