Provider Demographics
NPI:1639106925
Name:PRECISION SPINAL CARE LLC
Entity Type:Organization
Organization Name:PRECISION SPINAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-221-2880
Mailing Address - Street 1:620 S JEFFERS ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5351
Mailing Address - Country:US
Mailing Address - Phone:308-221-2880
Mailing Address - Fax:
Practice Address - Street 1:620 S JEFFERS ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5351
Practice Address - Country:US
Practice Address - Phone:308-221-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660095Medicare PIN
NE099571Medicare PIN
COC462098Medicare PIN
WYW9891Medicare PIN
COC461438Medicare PIN