Vander Broek, Douglas
Vander Broek, Douglas is an sole proprietor health care provider with primary practice located at 6511 Shenandoah Dr , Lincoln NE 68510-4195. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Vander Broek, Douglas can be contacted via phone (402) 730-4409.Contact Information
Primary practice address
6511 Shenandoah Dr
Lincoln NE 68510-4195
Phone: (402) 730-4409
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 790 | Nebraska |
Profile Details
| NPI number | 1699779934 |
|---|---|
| LBN Legal business name | Vander Broek, Douglas |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Nov 2nd, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699779934 | NPPES |
| Nebraska | MEDICAID | 47-067763401 | |
| Nebraska | Other | 47-0677634 | |
| Nebraska | Other | 091515 |
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