Provider Demographics
NPI:1538413075
Name:EXCEL CHIROPRACTIC AND WELLNESS P.C.
Entity type:Organization
Organization Name:EXCEL CHIROPRACTIC AND WELLNESS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ARON
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-875-1303
Mailing Address - Street 1:4220 LUCILE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6002
Mailing Address - Country:US
Mailing Address - Phone:402-327-0400
Mailing Address - Fax:402-327-0441
Practice Address - Street 1:4220 LUCILE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6002
Practice Address - Country:US
Practice Address - Phone:402-327-0400
Practice Address - Fax:402-327-0441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1476111N00000X
NE1627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE28051476Medicaid
NE10025893200Medicaid
NE281706Medicare PIN
NENA1742001Medicare PIN