Provider Demographics
NPI:1821143678
Name:WEE, DALE E (DC)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:E
Last Name:WEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DALE
Other - Middle Name:E
Other - Last Name:WEE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1008 W 1ST ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OGALLALA
Mailing Address - State:NE
Mailing Address - Zip Code:69153-1903
Mailing Address - Country:US
Mailing Address - Phone:308-284-2097
Mailing Address - Fax:308-284-2098
Practice Address - Street 1:1008 W 1ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:OGALLALA
Practice Address - State:NE
Practice Address - Zip Code:69153-1903
Practice Address - Country:US
Practice Address - Phone:308-284-2097
Practice Address - Fax:308-284-2098
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47076455400Medicaid
NE09598OtherBLUE CROSS BLUE SHIELD
NE091447Medicare UPIN