Provider Demographics
NPI:1275546335
Name:EARHART CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:EARHART CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:EARHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-228-3535
Mailing Address - Street 1:1301 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-2022
Mailing Address - Country:US
Mailing Address - Phone:402-228-3535
Mailing Address - Fax:402-228-7398
Practice Address - Street 1:1301 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-2022
Practice Address - Country:US
Practice Address - Phone:402-228-3535
Practice Address - Fax:402-228-7398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid
NE264191Medicare ID - Type Unspecified
NE=========Medicaid