Provider Demographics
NPI:1386673630
Name:FILLEY, RITA L (DC)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:L
Last Name:FILLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7640 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1508
Mailing Address - Country:US
Mailing Address - Phone:402-343-9006
Mailing Address - Fax:402-991-4203
Practice Address - Street 1:7640 PIERCE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1508
Practice Address - Country:US
Practice Address - Phone:402-343-9006
Practice Address - Fax:402-991-4203
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE1045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083213100Medicaid
NE36643OtherBLUE CROSS BLUE SHIELD OF
NE268525Medicare PIN
NEU46638Medicare UPIN