Provider Demographics
NPI:1548798739
Name:WOLFF, VICTOR T (PT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:T
Last Name:WOLFF
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34669
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-0669
Mailing Address - Country:US
Mailing Address - Phone:402-932-6791
Mailing Address - Fax:402-614-7835
Practice Address - Street 1:3201 FARNAM ST STE 6110
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3405
Practice Address - Country:US
Practice Address - Phone:402-932-9300
Practice Address - Fax:402-934-3544
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3701OtherNEBRASKA STATE LICENSE