Provider Demographics
NPI:1235316282
Name:CHIROPRACTIC NEUROLOGY & SPORTS REHAB, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC NEUROLOGY & SPORTS REHAB, LLC
Other - Org Name:CNS REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-420-2677
Mailing Address - Street 1:6200 S 58TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6406
Mailing Address - Country:US
Mailing Address - Phone:402-420-2677
Mailing Address - Fax:402-420-3030
Practice Address - Street 1:6200 S 58TH ST STE A
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6406
Practice Address - Country:US
Practice Address - Phone:402-420-2677
Practice Address - Fax:402-420-3030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025290300Medicaid
NE09828OtherBCBSNE
NE247828OtherMIDLANDS CHOICE
NE10025290300Medicaid
279382Medicare PIN