MEDICARE: CENTRAL CITY CHIROPRACTIC & WELLNESS CLINIC 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	772	NE

General Provider Information

NPI Number	:	1801139639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL CITY CHIROPRACTIC & WELLNESS CLINIC PC

Provider Business Mailing Address
First Line	:	215 G ST
Second Line	:
City	:	CENTRAL CITY
State	:	NE
Zip	:	68826-1729
Country	:	US
Telephone Number	:	308-946-2766
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 G ST
Second Line	:
City	:	CENTRAL CITY
State	:	NE
Zip	:	68826-1729
Country	:	US
Telephone Number	:	308-946-2766
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	DR. KURT DELL VOLLERS
Credential	:	D.C.
Telephone Number	:	308-946-2766

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	06/19/2015

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