Provider Demographics
NPI:1427092311
Name:STOVER CHIROPRACTIC LLC
Entity type:Organization
Organization Name:STOVER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:STOVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-488-2225
Mailing Address - Street 1:301 S 70TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2469
Mailing Address - Country:US
Mailing Address - Phone:402-488-2225
Mailing Address - Fax:866-863-3407
Practice Address - Street 1:301 S 70TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2469
Practice Address - Country:US
Practice Address - Phone:402-488-2225
Practice Address - Fax:866-863-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE$$$$$$$$$OtherSOCIAL SECURITY NUMBER
NE099596OtherMEDICARE ID
NE1002535900Medicaid
NE350919784OtherMEDICARE RR
NE44 00066OtherUNITED HEALTHCARE
NE5778OtherMIDLANDS CHOICE
NE36602OtherBCBS
NE85280OtherCOVENTRY