Provider Demographics
NPI:1093270670
Name:ADVANCED CHIROPRACTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BANGERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-328-0028
Mailing Address - Street 1:3121 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-4416
Mailing Address - Country:US
Mailing Address - Phone:402-328-0028
Mailing Address - Fax:402-328-0049
Practice Address - Street 1:6710 WOODLAND BLVD STE 3
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-9626
Practice Address - Country:US
Practice Address - Phone:402-328-0028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty