Provider Demographics
NPI:1598807026
Name:RUB, JEFFREY ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLAN
Last Name:RUB
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 1:1106 W BENJAMIN AVE
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2763
Mailing Address - Country:US
Mailing Address - Phone:402-844-3200
Mailing Address - Fax:402-844-5711
Practice Address - Street 1:1106 W BENJAMIN AVE
Practice Address - Street 2:SUITE 1100
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2763
Practice Address - Country:US
Practice Address - Phone:402-844-3200
Practice Address - Fax:402-844-5711
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE272813Medicare ID - Type Unspecified
U66818Medicare UPIN