Provider Demographics
NPI:1366638603
Name:VOITHOFER, BRYAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:THOMAS
Last Name:VOITHOFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10506 BURT CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2094
Mailing Address - Country:US
Mailing Address - Phone:402-676-9544
Mailing Address - Fax:
Practice Address - Street 1:10506 BURT CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2094
Practice Address - Country:US
Practice Address - Phone:402-676-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5075111N00000X
NE1742111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
No111N00000XChiropractic ProvidersChiropractor