MEDICARE: DR. DYLAN DRIVER DC

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	111NX0100X	Occupational Health Chiropractor	1784	NE

General Provider Information

NPI Number	:	1760804090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DYLAN DRIVER DC

Provider Business Mailing Address
First Line	:	2421 23RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2421 23RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3305
Country	:	US
Telephone Number	:	402-270-1062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2014
Last Update Date	:	12/28/2021

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Directions to “ DR. DYLAN DRIVER DC” Practice Location

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