Provider Demographics
NPI:1417141250
Name:GRIESER CHIROPRACTIC WELLNESS CENTER
Entity Type:Organization
Organization Name:GRIESER CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRIESER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-483-4646
Mailing Address - Street 1:7405 PIONEERS BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7554
Mailing Address - Country:US
Mailing Address - Phone:402-483-4646
Mailing Address - Fax:402-483-4649
Practice Address - Street 1:7405 PIONEERS BLVD STE E
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7554
Practice Address - Country:US
Practice Address - Phone:402-483-4646
Practice Address - Fax:402-483-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099646OtherMEDICARE GROUP NUMBER
NE100251926-00Medicaid
NEV03800Medicare UPIN