Provider Demographics
NPI:1033561857
Name:STONEBRAKER CHIROPRACTIC AND REHAB
Entity Type:Organization
Organization Name:STONEBRAKER CHIROPRACTIC AND REHAB
Other - Org Name:ATHLOS CHIROPRACTIC AND RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:STONEBRAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-334-9379
Mailing Address - Street 1:13227 B ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-3609
Mailing Address - Country:US
Mailing Address - Phone:402-334-9379
Mailing Address - Fax:
Practice Address - Street 1:13227 B ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3609
Practice Address - Country:US
Practice Address - Phone:402-334-9379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1783111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty