MEDICARE: A CENTER FOR CHIROPRACTIC & ALTERNATIVE MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1370	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114936366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CENTER FOR CHIROPRACTIC & ALTERNATIVE MEDICINE PC

Provider Business Mailing Address
First Line	:	1800 W PASEWALK STE 102
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701
Country	:	US
Telephone Number	:	402-371-4673
Fax Number	:	402-371-7431

Provider Business Practice Location Address
First Line	:	1800 W PASEWALK STE 102
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701
Country	:	US
Telephone Number	:	402-371-4673
Fax Number	:	402-371-7431

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANGELA THANE
Credential	:	D.C.
Telephone Number	:	402-316-9733

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	08/23/2018

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