Provider Demographics
NPI:1881889533
Name:SIZENBACH CHIROPRACTIC INC
Entity type:Organization
Organization Name:SIZENBACH CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIZENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-397-1800
Mailing Address - Street 1:10815 PRAIRIE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4827
Mailing Address - Country:US
Mailing Address - Phone:402-397-1800
Mailing Address - Fax:
Practice Address - Street 1:10815 PRAIRIE BROOK RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4827
Practice Address - Country:US
Practice Address - Phone:402-397-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
278769Medicare PIN