Provider Demographics
NPI:1518156587
Name:TRIUMPH 80 PC
Entity Type:Organization
Organization Name:TRIUMPH 80 PC
Other - Org Name:CHIROPRACTIC FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-375-3450
Mailing Address - Street 1:803 PROVIDENCE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NE
Mailing Address - Zip Code:68787-1590
Mailing Address - Country:US
Mailing Address - Phone:402-375-3450
Mailing Address - Fax:402-375-3450
Practice Address - Street 1:115 E SHERMAN ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:NE
Practice Address - Zip Code:68788-2229
Practice Address - Country:US
Practice Address - Phone:402-372-9900
Practice Address - Fax:402-372-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty