Provider Demographics
NPI:1356664072
Name:FREMONT CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:FREMONT CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERUSHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FRANZLUEBBERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-727-7219
Mailing Address - Street 1:PO BOX 1665
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68026-1665
Mailing Address - Country:US
Mailing Address - Phone:402-727-7219
Mailing Address - Fax:402-727-7369
Practice Address - Street 1:415 E 23RD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2393
Practice Address - Country:US
Practice Address - Phone:402-727-7219
Practice Address - Fax:402-727-7369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1431261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center