Provider Demographics
NPI:1205167301
Name:COMPLETE CHIROPRACTIC & WELLNESS CENTER OF HICKMAN LLC
Entity type:Organization
Organization Name:COMPLETE CHIROPRACTIC & WELLNESS CENTER OF HICKMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-792-2135
Mailing Address - Street 1:650 CHESTNUT ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-9764
Mailing Address - Country:US
Mailing Address - Phone:402-792-2135
Mailing Address - Fax:402-792-2136
Practice Address - Street 1:650 CHESTNUT ST
Practice Address - Street 2:#1
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-9764
Practice Address - Country:US
Practice Address - Phone:402-792-2135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1605111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty