Provider Demographics
NPI:1831495019
Name:GRIESS CHIROPRACTIC AND WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:GRIESS CHIROPRACTIC AND WELLNESS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUKAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GRIESS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-469-3710
Mailing Address - Street 1:207 S 16TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-3034
Mailing Address - Country:US
Mailing Address - Phone:402-694-0181
Mailing Address - Fax:402-694-0182
Practice Address - Street 1:207 S 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-3034
Practice Address - Country:US
Practice Address - Phone:402-694-0181
Practice Address - Fax:402-694-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025934300Medicaid
NENA1834OtherMEDICARE PTAN