MEDICARE: ABUNDANT LIFE FAMILY CHIROPRACTIC

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	1596	NE

General Provider Information

NPI Number	:	1508158346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANT LIFE FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	4716 PRESCOTT AVE
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5455
Country	:	US
Telephone Number	:	402-858-6130
Fax Number	:	402-881-8563

Provider Business Practice Location Address
First Line	:	4716 PRESCOTT AVE
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5455
Country	:	US
Telephone Number	:	402-858-6130
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN WEHLING
Credential	:	D.C.
Telephone Number	:	402-858-6130

Provider Enumeration Date	:	05/12/2011
Last Update Date	:	01/16/2012

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