Provider Demographics
NPI:1467603464
Name:ADVANCED CHIROPRACTIC & NEUROLOGY, PC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC & NEUROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCLAREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DACNB
Authorized Official - Phone:402-597-2869
Mailing Address - Street 1:12040 MCDERMOTT PLZ
Mailing Address - Street 2:STE 320
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2354
Mailing Address - Country:US
Mailing Address - Phone:402-597-2869
Mailing Address - Fax:402-597-2536
Practice Address - Street 1:12040 MCDERMOTT PLZ
Practice Address - Street 2:STE 320
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2354
Practice Address - Country:US
Practice Address - Phone:402-597-2869
Practice Address - Fax:402-597-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty