Provider Demographics
NPI:1932873510
Name:BAUER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BAUER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-336-7568
Mailing Address - Street 1:3758 N 156TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2800
Mailing Address - Country:US
Mailing Address - Phone:402-336-7568
Mailing Address - Fax:
Practice Address - Street 1:3758 N 156TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-2800
Practice Address - Country:US
Practice Address - Phone:402-336-7568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty