Provider Demographics
NPI:1639555956
Name:HUMPHREY CHIROPRACTIC
Entity Type:Organization
Organization Name:HUMPHREY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHEERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-923-0693
Mailing Address - Street 1:303 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUMPHREY
Mailing Address - State:NE
Mailing Address - Zip Code:68642-3163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMPHREY
Practice Address - State:NE
Practice Address - Zip Code:68642-3163
Practice Address - Country:US
Practice Address - Phone:402-923-0693
Practice Address - Fax:402-923-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1624261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1837Medicare PIN