Provider Demographics
NPI:1164966412
Name:XCEED CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:XCEED CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-786-0257
Mailing Address - Street 1:13220 CALLUM DR
Mailing Address - Street 2:STE 2
Mailing Address - City:WAVERLY
Mailing Address - State:NE
Mailing Address - Zip Code:68462-2561
Mailing Address - Country:US
Mailing Address - Phone:402-786-0257
Mailing Address - Fax:
Practice Address - Street 1:13220 CALLUM DR
Practice Address - Street 2:STE 2
Practice Address - City:WAVERLY
Practice Address - State:NE
Practice Address - Zip Code:68462-2561
Practice Address - Country:US
Practice Address - Phone:402-786-0257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026634600Medicaid