Provider Demographics
NPI:1164791208
Name:SEIM, JACKSON ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JACKSON
Middle Name:ADAM
Last Name:SEIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19115 MASON PLZ
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5659
Mailing Address - Country:US
Mailing Address - Phone:402-933-5000
Mailing Address - Fax:
Practice Address - Street 1:19115 MASON PLZ
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-5659
Practice Address - Country:US
Practice Address - Phone:402-933-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor