Provider Demographics
NPI:1710217740
Name:GENTZLER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GENTZLER CHIROPRACTIC LLC
Other - Org Name:GENTZLER SPINE AND SPORTS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:GENTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-261-6841
Mailing Address - Street 1:4400 S 70TH ST
Mailing Address - Street 2:STE 110
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6711
Mailing Address - Country:US
Mailing Address - Phone:402-261-6841
Mailing Address - Fax:402-261-6843
Practice Address - Street 1:4400 S 70TH ST
Practice Address - Street 2:STE 110
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6711
Practice Address - Country:US
Practice Address - Phone:402-261-6841
Practice Address - Fax:402-261-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1607261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center