Provider Demographics
NPI:1891736856
Name:STRECKER FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:STRECKER FAMILY CHIROPRACTIC LLC
Other - Org Name:STRECKER FAMILY CHIROPRACTIC PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTOR OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:KARENN
Authorized Official - Last Name:STRECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-805-5333
Mailing Address - Street 1:1135 COLLEGE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-4779
Mailing Address - Country:US
Mailing Address - Phone:620-805-5333
Mailing Address - Fax:
Practice Address - Street 1:1135 COLLEGE DR
Practice Address - Street 2:SUITE C
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-4779
Practice Address - Country:US
Practice Address - Phone:620-805-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024980300Medicaid
202230484OtherUNITED HEALTHCARE
NE09560OtherBCBS
278636Medicare ID - Type Unspecified
NE10024980300Medicaid