MEDICARE: DRIVER 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
1	111NX0100X	Occupational Health Chiropractor	1784	NE

General Provider Information

NPI Number	:	1982026720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRIVER CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2117 23RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3429
Country	:	US
Telephone Number	:	402-841-2038
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 23RD ST
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3429
Country	:	US
Telephone Number	:	402-841-2038
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. DYLAN DRIVER
Credential	:	D.C.
Telephone Number	:	402-841-2038

Provider Enumeration Date	:	01/14/2014
Last Update Date	:	02/02/2016

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Directions to “DRIVER CHIROPRACTIC LLC ” Practice Location

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