Provider Demographics
NPI:1316499346
Name:INSPIRE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:INSPIRE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SWELEY-BUETTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-382-0363
Mailing Address - Street 1:1804 FORREST ST STE 2
Mailing Address - Street 2:STE 2
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2110
Mailing Address - Country:US
Mailing Address - Phone:308-382-0363
Mailing Address - Fax:308-382-3644
Practice Address - Street 1:1804 FORREST ST STE 2
Practice Address - Street 2:STE 2
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2110
Practice Address - Country:US
Practice Address - Phone:308-382-0363
Practice Address - Fax:308-382-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NA2222Medicare PIN