Provider Demographics
NPI:1942523097
Name:HOOGEVEEN CHIROPRACTIC WELLNESS CENTER, P.C.
Entity Type:Organization
Organization Name:HOOGEVEEN CHIROPRACTIC WELLNESS CENTER, P.C.
Other - Org Name:HOOGEVEEN CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOGEVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-291-2580
Mailing Address - Street 1:1301 FORT CROOK RD S
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2940
Mailing Address - Country:US
Mailing Address - Phone:402-291-2580
Mailing Address - Fax:402-293-6436
Practice Address - Street 1:1301 FORT CROOK RD S
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2940
Practice Address - Country:US
Practice Address - Phone:402-291-2580
Practice Address - Fax:402-293-6436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEOTH000Medicare UPIN
NE42123210000Medicaid
NE271691Medicare PIN