Provider Demographics
NPI:1891834347
Name:ROSE CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:ROSE CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:NANELLEN
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-694-6900
Mailing Address - Street 1:1405 7TH ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-1141
Mailing Address - Country:US
Mailing Address - Phone:402-694-6900
Mailing Address - Fax:402-694-6904
Practice Address - Street 1:1405 7TH ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-1141
Practice Address - Country:US
Practice Address - Phone:402-694-6900
Practice Address - Fax:402-694-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09834OtherBCBS
NE=========00Medicaid
NE271325Medicare ID - Type Unspecified