Provider Demographics
NPI:1760711873
Name:LANDEN CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:LANDEN CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LANDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-432-8098
Mailing Address - Street 1:1115 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2920
Mailing Address - Country:US
Mailing Address - Phone:308-432-8098
Mailing Address - Fax:308-432-8442
Practice Address - Street 1:1115 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2920
Practice Address - Country:US
Practice Address - Phone:308-432-8098
Practice Address - Fax:308-432-8442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1600261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center