Provider Demographics
NPI:1972356046
Name:DJ CHIROPRACTIC LLC
Entity type:Organization
Organization Name:DJ CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-383-1350
Mailing Address - Street 1:8300 OLD CHENEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3540
Mailing Address - Country:US
Mailing Address - Phone:402-483-4646
Mailing Address - Fax:402-483-4649
Practice Address - Street 1:8300 OLD CHENEY RD STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3540
Practice Address - Country:US
Practice Address - Phone:402-483-4646
Practice Address - Fax:402-483-4649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty