Provider Demographics
NPI:1699210344
Name:FIRST CHIROPRACTIC CENTERS, PC
Entity Type:Organization
Organization Name:FIRST CHIROPRACTIC CENTERS, PC
Other - Org Name:FIRST CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:STOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-665-8073
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:110 E MAIN ST
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68718-0541
Mailing Address - Country:US
Mailing Address - Phone:402-408-6769
Mailing Address - Fax:402-408-6253
Practice Address - Street 1:110 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NE
Practice Address - Zip Code:68718-4408
Practice Address - Country:US
Practice Address - Phone:402-408-6769
Practice Address - Fax:402-408-6253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty