Provider Demographics
NPI:1417161746
Name:OAKVIEW CHIROPRACTIC CENTER P C
Entity Type:Organization
Organization Name:OAKVIEW CHIROPRACTIC CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHOCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-334-0840
Mailing Address - Street 1:16901 WRIGHT PLAZA
Mailing Address - Street 2:183
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130
Mailing Address - Country:US
Mailing Address - Phone:402-334-0840
Mailing Address - Fax:402-334-1471
Practice Address - Street 1:16901 WRIGHT PLAZA
Practice Address - Street 2:183
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130
Practice Address - Country:US
Practice Address - Phone:402-334-0840
Practice Address - Fax:402-334-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1004261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36645OtherBLUE CROSS BLUE SHIELD
NENA1072OtherMEDICARE PTAN
NENA1072OtherMEDICARE PTAN