Provider Demographics
NPI:1801063920
Name:SARPY CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:SARPY CHIROPRACTIC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-593-9930
Mailing Address - Street 1:10701 S 72ND ST
Mailing Address - Street 2:STE 120
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3427
Mailing Address - Country:US
Mailing Address - Phone:402-593-9930
Mailing Address - Fax:402-593-0310
Practice Address - Street 1:10701 S 72ND ST
Practice Address - Street 2:STE 120
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3427
Practice Address - Country:US
Practice Address - Phone:402-593-9930
Practice Address - Fax:402-593-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid