Provider Demographics
NPI:1114672359
Name:SARPY CHIROPRACTIC - WEST O, LLC
Entity Type:Organization
Organization Name:SARPY CHIROPRACTIC - WEST O, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-593-9930
Mailing Address - Street 1:16909 BURKE ST STE 124
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2268
Mailing Address - Country:US
Mailing Address - Phone:402-593-9930
Mailing Address - Fax:
Practice Address - Street 1:16909 BURKE ST STE 124
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2268
Practice Address - Country:US
Practice Address - Phone:402-593-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty