Provider Demographics
NPI:1396815676
Name:TRIBA, THOMAS A (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:TRIBA
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 1:2720 SO 114 ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4712
Mailing Address - Country:US
Mailing Address - Phone:402-330-1652
Mailing Address - Fax:402-330-6342
Practice Address - Street 1:2720 SO 114 ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4712
Practice Address - Country:US
Practice Address - Phone:402-330-1652
Practice Address - Fax:402-330-6342
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
091567Medicare ID - Type Unspecified