Provider Demographics
NPI:1356746242
Name:CLARKSON CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CLARKSON CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GROENE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-352-3399
Mailing Address - Street 1:410 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER
Mailing Address - State:NE
Mailing Address - Zip Code:68661-1348
Mailing Address - Country:US
Mailing Address - Phone:402-352-3399
Mailing Address - Fax:402-352-3099
Practice Address - Street 1:410 W 16TH ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-1348
Practice Address - Country:US
Practice Address - Phone:402-352-3399
Practice Address - Fax:402-352-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty