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Individual

CASEY J IVERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1804 WEST FORREST STREET, GRAND ISLAND, NE 68802-2110
(308) 382-3666
(308) 382-3644
Mailing address
PO BOX 2371, 1804 WEST FORREST STREET, GRAND ISLAND, NE 68802-2371
(308) 382-3666
(308) 382-3644

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
786
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09538
BCBS
NE
01
22491
MIDLANDS CHOICE
NE
05
47-068753000
NE
05
47068753000
NE
Enumeration date
09/28/2006
Last updated
05/09/2023
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