Provider Demographics
NPI:1720255714
Name:COMPLETE HEALTH CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:COMPLETE HEALTH CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-488-0288
Mailing Address - Street 1:2120 S 56TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2118
Mailing Address - Country:US
Mailing Address - Phone:402-488-0288
Mailing Address - Fax:402-488-0289
Practice Address - Street 1:2120 S 56TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2118
Practice Address - Country:US
Practice Address - Phone:402-488-0288
Practice Address - Fax:402-488-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025432300Medicaid
NE10025432300Medicaid
NE279902Medicare PIN