Provider Demographics
NPI:1801139639
Name:CENTRAL CITY CHIROPRACTIC & WELLNESS CLINIC PC
Entity type:Organization
Organization Name:CENTRAL CITY CHIROPRACTIC & WELLNESS CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:DELL
Authorized Official - Last Name:VOLLERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-946-2766
Mailing Address - Street 1:215 G ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-1729
Mailing Address - Country:US
Mailing Address - Phone:308-946-2766
Mailing Address - Fax:
Practice Address - Street 1:215 G ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-1729
Practice Address - Country:US
Practice Address - Phone:308-946-2766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty