Provider Demographics
NPI:1790976595
Name:HINZE CHIROPRACTIC
Entity Type:Organization
Organization Name:HINZE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HINZE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-345-8699
Mailing Address - Street 1:306 W D ST
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3682
Mailing Address - Country:US
Mailing Address - Phone:308-345-8699
Mailing Address - Fax:308-345-8698
Practice Address - Street 1:306 W D ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3682
Practice Address - Country:US
Practice Address - Phone:308-345-8699
Practice Address - Fax:308-345-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA8007OtherRRB PTAN
NE=========00Medicaid
NEU88346Medicare UPIN
NE099141Medicare PIN