Provider Demographics
NPI:1134441603
Name:INLINE HEALING
Entity type:Organization
Organization Name:INLINE HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-770-1260
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:BEATRICE
Mailing Address - State:NE
Mailing Address - Zip Code:68310-4402
Mailing Address - Country:US
Mailing Address - Phone:402-770-1260
Mailing Address - Fax:
Practice Address - Street 1:223 S 6TH ST
Practice Address - Street 2:
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-4402
Practice Address - Country:US
Practice Address - Phone:402-770-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1606261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center