Provider Demographics
NPI:1629873518
Name:ONE80 CHIROPRACTIC AND FUNCTIONAL REHAB LLC
Entity type:Organization
Organization Name:ONE80 CHIROPRACTIC AND FUNCTIONAL REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-770-0492
Mailing Address - Street 1:120 REGENCY PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4301
Mailing Address - Country:US
Mailing Address - Phone:720-770-0492
Mailing Address - Fax:
Practice Address - Street 1:120 REGENCY PKWY STE 104
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4301
Practice Address - Country:US
Practice Address - Phone:720-770-0492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty