MEDICARE: HACKBART CHIROPRACTIC 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	932	NE

General Provider Information

NPI Number	:	1467672865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HACKBART CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	508 1ST ST.
Second Line	:	PO BOX 744
City	:	MILFORD
State	:	NE
Zip	:	68405-0744
Country	:	US
Telephone Number	:	402-761-3100
Fax Number	:	402-761-3100

Provider Business Practice Location Address
First Line	:	508 1ST ST.
Second Line	:
City	:	MILFORD
State	:	NE
Zip	:	68405-0744
Country	:	US
Telephone Number	:	402-761-3100
Fax Number	:	402-761-3100

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DARYL LEE HACKBART
Credential	:	D.C.
Telephone Number	:	402-761-3100

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	06/17/2008

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