Individual
KEVIN ROSS MICHAELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
502 W 1ST ST, MCCOOK, NE 69001-3101
(308) 345-2000
(308) 345-2001
Mailing address
502 W 1ST ST, MCCOOK, NE 69001-3101
(308) 345-2000
(308) 345-2001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1324
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09603
BCBS
NE
05
—
10025083900
—
NE
01
—
242268
MIDLANDS CHOICE
NE
Enumeration date
10/05/2006
Last updated
07/08/2007
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