Provider Demographics
NPI:1124128947
Name:HINZE, TODD STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:STEVEN
Last Name:HINZE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W D ST
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-3682
Mailing Address - Country:US
Mailing Address - Phone:308-345-8699
Mailing Address - Fax:308-345-8698
Practice Address - Street 1:306 W D ST
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3682
Practice Address - Country:US
Practice Address - Phone:308-345-8699
Practice Address - Fax:308-345-8698
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1272111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00072561OtherRRB PTAN
NE47084476300Medicaid
NE47084476300Medicaid
NE099141Medicare ID - Type UnspecifiedPROVIDER NUMBER