Provider Demographics
NPI:1134640055
Name:XCEED CHIROPRACTIC & WELLNESS CLINIC PC
Entity Type:Organization
Organization Name:XCEED CHIROPRACTIC & WELLNESS CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-470-7050
Mailing Address - Street 1:13220 CALLUM DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:NE
Mailing Address - Zip Code:68462-2562
Mailing Address - Country:US
Mailing Address - Phone:402-786-0257
Mailing Address - Fax:402-786-0258
Practice Address - Street 1:13220 CALLUM DR STE 2
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:NE
Practice Address - Zip Code:68462-2562
Practice Address - Country:US
Practice Address - Phone:402-786-0257
Practice Address - Fax:402-786-0258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty