Provider Demographics
NPI:1578504353
Name:CORNHUSKER CHIROPRACTIC PC
Entity Type:Organization
Organization Name:CORNHUSKER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR PRESIDENT OF CORNHUSKE
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-466-1288
Mailing Address - Street 1:2949 N 27TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-1476
Mailing Address - Country:US
Mailing Address - Phone:402-466-1288
Mailing Address - Fax:402-466-1288
Practice Address - Street 1:2949 N 27TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1476
Practice Address - Country:US
Practice Address - Phone:402-466-1288
Practice Address - Fax:402-466-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025333800Medicaid
36679OtherBCBS
NE10025333800Medicaid
36679OtherBCBS
279777Medicare ID - Type UnspecifiedBILL G WRIGHT PROVIDER