Provider Demographics
NPI:1023190154
Name:NORTHWEST CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:NORTHWEST CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIWA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-933-2273
Mailing Address - Street 1:5148 N 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-2830
Mailing Address - Country:US
Mailing Address - Phone:402-933-2273
Mailing Address - Fax:402-502-9255
Practice Address - Street 1:5148 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-2830
Practice Address - Country:US
Practice Address - Phone:402-933-2273
Practice Address - Fax:402-502-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty