Organization
RIDER CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHELLE LEE RIDER D.C. (PRESIDENT)
(402) 990-0648
Entity
Organization
Contact information
Practice address
13220 CALLUM DR, SUITE 2, WAVERLY, NE 68462-2561
(402) 990-0648
Mailing address
200 NORTH STREET, GREENWOOD, NE 68366-2502
(402) 990-0648
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1615
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1615
CHIROPRACTIC LICENSE
NE
Enumeration date
06/10/2010
Last updated
07/23/2010
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