Provider Demographics
NPI:1114273604
Name:HEALTHY BACK CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HEALTHY BACK CHIROPRACTIC LLC
Other - Org Name:THE HEALTHY BACK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HOPPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-395-6957
Mailing Address - Street 1:1106 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-1362
Mailing Address - Country:US
Mailing Address - Phone:402-395-6957
Mailing Address - Fax:402-395-9918
Practice Address - Street 1:228 S 11TH ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1157
Practice Address - Country:US
Practice Address - Phone:402-395-6957
Practice Address - Fax:402-395-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty