Provider Demographics
NPI:1154935807
Name:ESHELMAN, BRUCE (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:ESHELMAN
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 1:6720 S 168TH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-3168
Mailing Address - Country:US
Mailing Address - Phone:531-999-1031
Mailing Address - Fax:
Practice Address - Street 1:6720 S 168TH ST STE 3
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-3168
Practice Address - Country:US
Practice Address - Phone:531-999-1031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2056111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor