Provider Demographics
NPI:1073840989
Name:DFD PC
Entity Type:Organization
Organization Name:DFD PC
Other - Org Name:SPINAL BALANCE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-452-3400
Mailing Address - Street 1:5332 S 138TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-2974
Mailing Address - Country:US
Mailing Address - Phone:402-452-3400
Mailing Address - Fax:402-452-3401
Practice Address - Street 1:5332 S 138TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-2974
Practice Address - Country:US
Practice Address - Phone:402-452-3400
Practice Address - Fax:402-452-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1441111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE280924Medicare PIN