Provider Demographics
NPI:1598417594
Name:OHANA CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:OHANA CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MILISA
Authorized Official - Middle Name:RAINE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-991-9257
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:NE
Mailing Address - Zip Code:69154-0043
Mailing Address - Country:US
Mailing Address - Phone:308-244-1872
Mailing Address - Fax:
Practice Address - Street 1:390 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:NE
Practice Address - Zip Code:69154-6112
Practice Address - Country:US
Practice Address - Phone:308-244-1872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHANA CHIROPRACTIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE2119OtherSTATE CHIROPRACTIC LICENSE