Provider Demographics
NPI:1619163508
Name:HINZE CHIROPRACTIC CENTER P C
Entity Type:Organization
Organization Name:HINZE CHIROPRACTIC CENTER P C
Other - Org Name:DAVID CITY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-367-6061
Mailing Address - Street 1:528 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVID CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68632-1624
Mailing Address - Country:US
Mailing Address - Phone:402-367-6061
Mailing Address - Fax:402-367-4220
Practice Address - Street 1:528 N 4TH ST
Practice Address - Street 2:
Practice Address - City:DAVID CITY
Practice Address - State:NE
Practice Address - Zip Code:68632-1624
Practice Address - Country:US
Practice Address - Phone:402-367-6061
Practice Address - Fax:402-367-4220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HINZE CHIROPRACTIC CENTER, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-24
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE974111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========05Medicaid
NE091594Medicare PIN