Provider Demographics
NPI:1235325572
Name:MEINECKE CHIROPRACTIC P C
Entity Type:Organization
Organization Name:MEINECKE CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEINECKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:308-381-8299
Mailing Address - Street 1:2838 OLD FAIR RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5222
Mailing Address - Country:US
Mailing Address - Phone:308-381-8299
Mailing Address - Fax:308-381-7426
Practice Address - Street 1:2838 OLD FAIR RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-5222
Practice Address - Country:US
Practice Address - Phone:308-381-8299
Practice Address - Fax:308-381-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid
NE275168Medicare PIN