Provider Demographics
NPI:1790311090
Name:SARPY CHIROPRACTIC ELKHORN LLC
Entity Type:Organization
Organization Name:SARPY CHIROPRACTIC ELKHORN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-593-9930
Mailing Address - Street 1:1520 N 205TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4729
Mailing Address - Country:US
Mailing Address - Phone:402-593-9930
Mailing Address - Fax:
Practice Address - Street 1:1520 N 205TH ST STE 105
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4729
Practice Address - Country:US
Practice Address - Phone:402-593-9930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty