Provider Demographics
NPI:1902589096
Name:308 CHIROPRACTIC INC
Entity Type:Organization
Organization Name:308 CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-777-2476
Mailing Address - Street 1:801 W C ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3592
Mailing Address - Country:US
Mailing Address - Phone:308-777-2476
Mailing Address - Fax:
Practice Address - Street 1:801 W C ST STE 3
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3592
Practice Address - Country:US
Practice Address - Phone:308-777-2476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1821598251OtherTYPE 1 NPI
NE62720092800Medicaid