Provider Demographics
NPI:1508867151
Name:HINZE CHIROPRACTIC CENTER P C
Entity Type:Organization
Organization Name:HINZE CHIROPRACTIC CENTER P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:HINZE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-564-9447
Mailing Address - Street 1:2421 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-3305
Mailing Address - Country:US
Mailing Address - Phone:402-564-9447
Mailing Address - Fax:402-564-7888
Practice Address - Street 1:2421 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3305
Practice Address - Country:US
Practice Address - Phone:402-564-9447
Practice Address - Fax:402-564-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-04
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE092170OtherPTAN
NE9515OtherBLUE CROSS BLUE SHIELD
NE=========13Medicaid
NE=========13Medicaid