Provider Demographics
NPI:1508158346
Name:ABUNDANT LIFE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:ABUNDANT LIFE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-858-6130
Mailing Address - Street 1:4716 PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5455
Mailing Address - Country:US
Mailing Address - Phone:402-858-6130
Mailing Address - Fax:402-881-8563
Practice Address - Street 1:4716 PRESCOTT AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5455
Practice Address - Country:US
Practice Address - Phone:402-858-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty