Provider Demographics
NPI:1760660104
Name:WHOLE BODY HEALTH CHIROPRACITC, PC
Entity Type:Organization
Organization Name:WHOLE BODY HEALTH CHIROPRACITC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOREHEAD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:402-393-0280
Mailing Address - Street 1:2430 S 73RD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2397
Mailing Address - Country:US
Mailing Address - Phone:402-393-0280
Mailing Address - Fax:402-393-0262
Practice Address - Street 1:2430 S 73RD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2397
Practice Address - Country:US
Practice Address - Phone:402-393-0280
Practice Address - Fax:402-393-0262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025236300Medicaid
NE278548Medicare PIN
NEV03717Medicare UPIN