Provider Demographics
NPI:1619399375
Name:FINISH LINE CHIROPRACTIC & ACUPUNCTURE
Entity Type:Organization
Organization Name:FINISH LINE CHIROPRACTIC & ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:NEKOLITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-336-9979
Mailing Address - Street 1:403 E HYNES AVE
Mailing Address - Street 2:
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1301
Mailing Address - Country:US
Mailing Address - Phone:402-336-9979
Mailing Address - Fax:
Practice Address - Street 1:403 E HYNES AVE
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1301
Practice Address - Country:US
Practice Address - Phone:402-336-9979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1785261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center