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General NPI Number Information
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NPI Number | 1720875891
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Entity Type | Organization
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Legal Business Name | TJB CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 7111 A ST STE 100
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City | LINCOLN
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State | NE
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Zip | 68510-4283
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Country | US
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Telephone | 402-489-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 10730 N 138TH ST
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City | WAVERLY
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State | NE
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Zip | 68462-1005
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Country | US
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Telephone | 402-450-3138
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | TANNER J BURT
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Credential | DC
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Telephone | 402-450-3138
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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 |
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License Number State |
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