Provider Demographics
NPI:1578730842
Name:CHAFFIN CHIROPRACTIC CLINIC, P.C.
Entity Type:Organization
Organization Name:CHAFFIN CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-346-5191
Mailing Address - Street 1:147 S 8TH ST
Mailing Address - Street 2:PO BOX 515
Mailing Address - City:BURWELL
Mailing Address - State:NE
Mailing Address - Zip Code:68823-6003
Mailing Address - Country:US
Mailing Address - Phone:308-346-5191
Mailing Address - Fax:308-346-5191
Practice Address - Street 1:147 S 8TH ST
Practice Address - Street 2:
Practice Address - City:BURWELL
Practice Address - State:NE
Practice Address - Zip Code:68823-6003
Practice Address - Country:US
Practice Address - Phone:308-346-5191
Practice Address - Fax:308-346-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099717Medicare PIN