| Vitality Chiropractic Lifestyle Center | |
|
10 N Spruce St, Ogallala, NE 69153-2549 | |
| (401) 310-5790 | |
| Not Available |
| Full Name | Vitality Chiropractic Lifestyle Center |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 10 N Spruce St, Ogallala, Nebraska |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376830810 | NPI | - | NPPES |
| 10025511400 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1567 (Nebraska) | Primary |
| Provider Name | Nicolas J Fanning |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760616023 PECOS PAC ID: 8426104183 Enrollment ID: I20090922000104 |
| Mailing Address | Practice Location Address |
|---|---|
| Vitality Chiropractic Lifestyle Center Po Box 96, Ogallala, NE 69153-0096 Ph: (402) 310-5790 | Vitality Chiropractic Lifestyle Center 10 N Spruce St, Ogallala, NE 69153-2549 Ph: (401) 310-5790 |
Hanna Nikole Davis, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 106 W 1st St, Ogallala, NE 69153 Phone: 308-212-0417 | |
Tara Christine Sutton, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 600 E 1st St, Ogallala, NE 69153 Phone: 308-284-2068 | |
Dale E Wee, Dc Pc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1008 W 1st St, Suite 1, Ogallala, NE 69153 Phone: 308-284-2097 Fax: 308-284-2098 | |
Dr. Nicolas Jim Fanning, D.C., M.S. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 10 N Spruce St, Ogallala, NE 69153 Phone: 402-310-5790 | |
Dr. Dale E Wee, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1008 W 1st St, Suite 1, Ogallala, NE 69153 Phone: 308-284-2097 Fax: 308-284-2098 |