Provider Demographics
NPI:1982026720
Name:DRIVER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DRIVER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-841-2038
Mailing Address - Street 1:2117 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-3429
Mailing Address - Country:US
Mailing Address - Phone:402-841-2038
Mailing Address - Fax:
Practice Address - Street 1:2117 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3429
Practice Address - Country:US
Practice Address - Phone:402-841-2038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1784111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty