Provider Demographics
NPI:1538603378
Name:STUBBS CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:STUBBS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-293-5135
Mailing Address - Street 1:8380 OLD CHENEY RD
Mailing Address - Street 2:#2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3516
Mailing Address - Country:US
Mailing Address - Phone:308-293-5135
Mailing Address - Fax:
Practice Address - Street 1:8380 OLD CHENEY RD
Practice Address - Street 2:#2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3516
Practice Address - Country:US
Practice Address - Phone:308-293-5135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1661111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025791500Medicaid