| Functional Performance Chiropractic & Wellness | |
|
15811 W Dodge Rd Ste 152 Omaha NE 68118-4013 | |
| (402) 999-8166 | |
| (402) 934-7681 |
| Full Name | Functional Performance Chiropractic & Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 15811 W Dodge Rd Ste 152, Omaha, Nebraska |
| Authorized Official Name and Position | Nathan K Lauenstein (OWNER) |
| Authorized Official Contact | 4029998166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Functional Performance Chiropractic & Wellness 15811 W Dodge Rd Ste 152 Omaha NE 68118-4013 Ph: (402) 999-8166 | Functional Performance Chiropractic & Wellness 15811 W Dodge Rd Ste 152 Omaha NE 68118-4013 Ph: (402) 999-8166 |
| NPI Number | 1053728451 |
|---|---|
| Provider Enumeration Date | 07/17/2014 |
| Last Update Date | 08/14/2020 |
| Medicare PECOS PAC ID | 7315233681 |
|---|---|
| Medicare Enrollment ID | O20160913001301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053728451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1796 (Nebraska) | Primary |
| Provider Name | Nathan Kyle Lauenstein |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588079131 PECOS PAC ID: 2668768946 Enrollment ID: I20160913001684 |
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