| Awaken Chiropractic Llc | |
|
14135 Q St, Omaha, NE 68137-2600 | |
| (402) 881-0883 | |
| Not Available |
| Full Name | Awaken Chiropractic Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 14135 Q St, Omaha, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184145823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1930 (Iowa) | Primary |
| Provider Name | Gabriel Long |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902327646 PECOS PAC ID: 9830460674 Enrollment ID: I20170811002652 |
| Provider Name | Anthony Justin Moody |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144899428 PECOS PAC ID: 8820490998 Enrollment ID: I20210712003168 |
| Provider Name | Jordan Thomas Peterson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265197107 PECOS PAC ID: 0143610220 Enrollment ID: I20211203001042 |
| Mailing Address | Practice Location Address |
|---|---|
| Awaken Chiropractic Llc 14135 Q St, Omaha, NE 68137-2600 Ph: (402) 881-0883 | Awaken Chiropractic Llc 14135 Q St, Omaha, NE 68137-2600 Ph: (402) 881-0883 |
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