Provider Demographics
NPI:1285706119
Name:OSBORN CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:OSBORN CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-423-8226
Mailing Address - Street 1:6001 SOUTH 58TH STREET
Mailing Address - Street 2:SUITE F
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3644
Mailing Address - Country:US
Mailing Address - Phone:402-423-8226
Mailing Address - Fax:402-423-8712
Practice Address - Street 1:6001 SOUTH 58TH STREET
Practice Address - Street 2:SUITE F
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3644
Practice Address - Country:US
Practice Address - Phone:402-423-8226
Practice Address - Fax:402-423-8712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10123OtherMIDLANDS CHOICE
44-00035OtherUNITED HEALTHCARE
99552OtherBLUE CROSS/BLUE SHIELD
350054337OtherMEDICARE RAILROAD
NE=========00Medicaid
NE=========00Medicaid
99552OtherBLUE CROSS/BLUE SHIELD