Provider Demographics
NPI:1306870324
Name:BUETTENBACK INC.
Entity type:Organization
Organization Name:BUETTENBACK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BUETTENBACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-476-8483
Mailing Address - Street 1:5533 NW 1ST ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4474
Mailing Address - Country:US
Mailing Address - Phone:402-476-8483
Mailing Address - Fax:402-742-3783
Practice Address - Street 1:5533 NW 1ST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4474
Practice Address - Country:US
Practice Address - Phone:402-476-8483
Practice Address - Fax:402-742-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025227300Medicaid
NE099673Medicare ID - Type Unspecified
NEU99669Medicare UPIN