Provider Demographics
NPI:1942851100
Name:MILLARD FAMILY CHIROPRACTIC OF PAPILLION LLC
Entity Type:Organization
Organization Name:MILLARD FAMILY CHIROPRACTIC OF PAPILLION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-934-7557
Mailing Address - Street 1:17830 BAY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2239
Mailing Address - Country:US
Mailing Address - Phone:402-578-7119
Mailing Address - Fax:402-934-8937
Practice Address - Street 1:1401 S WASHINGTON ST STE E
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2474
Practice Address - Country:US
Practice Address - Phone:402-934-7557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty