Provider Demographics
NPI:1255664579
Name:STAUFFERS CHIROPRACTIC
Entity Type:Organization
Organization Name:STAUFFERS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNEAL
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:STAUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:402-488-8801
Mailing Address - Street 1:735 S 56TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-3960
Mailing Address - Country:US
Mailing Address - Phone:402-488-8801
Mailing Address - Fax:402-488-8801
Practice Address - Street 1:735 S 56TH ST STE 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-3960
Practice Address - Country:US
Practice Address - Phone:402-488-8801
Practice Address - Fax:402-488-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-18
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE269309Medicare PIN
NEU80504Medicare UPIN