Organization
WELLNESSONE OF LINCOLN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L PORTER (CFO)
(402) 420-5303
Entity
Organization
Contact information
Practice address
4210 PIONEER WOODS DR., STE B, LINCOLN, NE 68506-7550
(402) 484-0200
(402) 484-5677
Mailing address
4210 PIONEER WOODS DR., STE B, LINCOLN, NE 68506-7550
(402) 484-0200
(402) 484-5677
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1553
NE
111N00000X
Chiropractor
968
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09751
BLUE CROSS BLUE SHIELD NE
NE
05
—
10025154200
—
NE
Enumeration date
05/24/2007
Last updated
06/13/2013
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