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NPI Code Detail

MEDICARE: BEYOND THE SPINE CHIROPRACTIC, LLC

MEDICARE: BEYOND THE SPINE CHIROPRACTIC, LLC
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
1261QH0100XHealth Service Clinic/Center
2111N00000XChiropractor

General Provider Information

NPI Number : 1902373822
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEYOND THE SPINE CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 306 N 7TH ST
Second Line :
City : PLATTSMOUTH
State : NE
Zip : 68048-1310
Country : US
Telephone Number : 402-298-5774
Fax Number : 402-999-0871
Provider Business Practice Location Address
First Line : 306 N 7TH ST
Second Line :
City : PLATTSMOUTH
State : NE
Zip : 68048-1310
Country : US
Telephone Number : 402-298-5774
Fax Number : 402-999-0871
Authorized Official
Title or Position : OWNER
Name : COURTNEY M BRADLEY
Credential : DC
Telephone Number : 402-881-9638
Provider Enumeration Date : 10/29/2018
Last Update Date : 03/26/2021

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Directions to “BEYOND THE SPINE CHIROPRACTIC, LLC ” Practice Location

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