Provider Demographics
NPI:1073813192
Name:NEBRASKALAND CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:NEBRASKALAND CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-872-6225
Mailing Address - Street 1:551 S E ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-2529
Mailing Address - Country:US
Mailing Address - Phone:083-872-6225
Mailing Address - Fax:308-872-2331
Practice Address - Street 1:551 S E ST
Practice Address - Street 2:
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-2529
Practice Address - Country:US
Practice Address - Phone:083-872-6225
Practice Address - Fax:308-872-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1599111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025907300Medicaid