Provider Demographics
NPI:1467672865
Name:HACKBART CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HACKBART CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HACKBART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-761-3100
Mailing Address - Street 1:508 1ST ST.
Mailing Address - Street 2:PO BOX 744
Mailing Address - City:MILFORD
Mailing Address - State:NE
Mailing Address - Zip Code:68405-0744
Mailing Address - Country:US
Mailing Address - Phone:402-761-3100
Mailing Address - Fax:402-761-3100
Practice Address - Street 1:508 1ST ST.
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NE
Practice Address - Zip Code:68405-0744
Practice Address - Country:US
Practice Address - Phone:402-761-3100
Practice Address - Fax:402-761-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NENA1066Medicare PIN