Provider Demographics
NPI:1568547925
Name:HEARTLAND CHIROPRACTIC CENTER P.C.
Entity Type:Organization
Organization Name:HEARTLAND CHIROPRACTIC CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-237-0648
Mailing Address - Street 1:4009 6TH AVE
Mailing Address - Street 2:SUITE 55
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2386
Mailing Address - Country:US
Mailing Address - Phone:308-237-0648
Mailing Address - Fax:308-236-9197
Practice Address - Street 1:4009 6TH AVE
Practice Address - Street 2:SUITE 55
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2386
Practice Address - Country:US
Practice Address - Phone:308-237-0648
Practice Address - Fax:308-236-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE232852OtherMIDLANDS CHOICE
NE99502OtherBLUE CROSS BLUE SHIELD
NE=========-00Medicaid
NEU59428Medicare UPIN
NE=========-00Medicaid