Provider Demographics
NPI:1831494608
Name:BLAIR CHIROPRACTIC CENTRE, LLC
Entity type:Organization
Organization Name:BLAIR CHIROPRACTIC CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-426-4443
Mailing Address - Street 1:1729 WASHINGTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BLAIR
Mailing Address - State:NE
Mailing Address - Zip Code:68008-1501
Mailing Address - Country:US
Mailing Address - Phone:402-426-4443
Mailing Address - Fax:402-426-4604
Practice Address - Street 1:1729 WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:BLAIR
Practice Address - State:NE
Practice Address - Zip Code:68008-1501
Practice Address - Country:US
Practice Address - Phone:402-426-4443
Practice Address - Fax:402-426-4604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLAIR CHIROPRACTIC CENTRE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-25
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty