Provider Demographics
NPI:1467632950
Name:MILLIGAN CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:MILLIGAN CHIROPRACTIC, P.C.
Other - Org Name:MILLIGAN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-698-0525
Mailing Address - Street 1:317 WEST 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847
Mailing Address - Country:US
Mailing Address - Phone:308-698-0525
Mailing Address - Fax:308-698-0528
Practice Address - Street 1:317 WEST 11TH STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-698-0525
Practice Address - Fax:308-698-0528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1385111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025330300Medicaid
NE278842Medicare PIN
NE10025330300Medicaid
NEV05588Medicare UPIN