Provider Demographics
NPI:1972194488
Name:HYDE FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HYDE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-430-2849
Mailing Address - Street 1:8215 NORTHWOODS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-3009
Mailing Address - Country:US
Mailing Address - Phone:402-442-0333
Mailing Address - Fax:
Practice Address - Street 1:8215 NORTHWOODS DR STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-3009
Practice Address - Country:US
Practice Address - Phone:402-442-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty