Provider Demographics
NPI:1366614679
Name:HEARTLAND FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:HEARTLAND FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WINHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-324-2294
Mailing Address - Street 1:114 E 6TH ST
Mailing Address - Street 2:PO BOX 842
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-1905
Mailing Address - Country:US
Mailing Address - Phone:308-324-2294
Mailing Address - Fax:308-324-2094
Practice Address - Street 1:114 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-1905
Practice Address - Country:US
Practice Address - Phone:308-324-2294
Practice Address - Fax:308-324-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025610100Medicaid