Provider Demographics
NPI:1154921476
Name:LAURSEN, TERENCE (DC)
Entity type:Individual
Prefix:
First Name:TERENCE
Middle Name:
Last Name:LAURSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:LAURSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:7116 N 102ND CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-3059
Mailing Address - Country:US
Mailing Address - Phone:402-933-9799
Mailing Address - Fax:402-933-9782
Practice Address - Street 1:7116 N 102ND CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-3059
Practice Address - Country:US
Practice Address - Phone:402-933-9799
Practice Address - Fax:402-933-9782
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor