Provider Demographics
NPI:1831202407
Name:SPEECE, BRETT ROY (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ROY
Last Name:SPEECE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SOUTH EXETER AVE.
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NE
Mailing Address - Zip Code:68351-0016
Mailing Address - Country:US
Mailing Address - Phone:402-266-2123
Mailing Address - Fax:402-266-2186
Practice Address - Street 1:115 SOUTH EXETER AVE.
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NE
Practice Address - Zip Code:68351-0016
Practice Address - Country:US
Practice Address - Phone:402-266-2123
Practice Address - Fax:402-266-2186
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083159100Medicaid
NE272689Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NE47083159100Medicaid