Organization
GRAND ISLAND CHIROPRACTIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY L DUNAGAN D.C. (OWNER)
(308) 381-1312
Entity
Organization
Contact information
Practice address
620 N CUSTER AVE, GRAND ISLAND, NE 68803-4375
(308) 381-1312
Mailing address
620 N CUSTER AVE, GRAND ISLAND, NE 68803-4375
(308) 381-1312
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
638
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009513
BLUE CROSS BLUE SHIELD
NE
Enumeration date
05/09/2007
Last updated
05/15/2008
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