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General NPI Number Information
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NPI Number | 1801139639
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Entity Type | Organization
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Legal Business Name | CENTRAL CITY CHIROPRACTIC & WELLNESS CLINIC PC
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 215 G ST
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City | CENTRAL CITY
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State | NE
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Zip | 68826-1729
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Country | US
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Telephone | 308-946-2766
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Fax |
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Provider Business Mailing Address
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Address Line | 215 G ST
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City | CENTRAL CITY
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State | NE
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Zip | 68826-1729
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Country | US
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Telephone | 308-946-2766
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. KURT DELL VOLLERS
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Credential | D.C.
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Telephone | 308-946-2766
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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 | 772
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License Number State | NE
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