Provider Demographics
NPI:1497975775
Name:FAMILY FIRST CHIROPRACTIC L.L.C
Entity Type:Organization
Organization Name:FAMILY FIRST CHIROPRACTIC L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-884-4100
Mailing Address - Street 1:18025 OAK ST
Mailing Address - Street 2:#A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-6093
Mailing Address - Country:US
Mailing Address - Phone:402-884-4100
Mailing Address - Fax:402-884-9993
Practice Address - Street 1:18025 OAK ST. SUITE A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130
Practice Address - Country:US
Practice Address - Phone:402-884-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099962Medicare PIN