Provider Demographics
NPI:1659313666
Name:THONE, JACOB ABRAHM (DC)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:ABRAHM
Last Name:THONE
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 1:1800 W PASEWALK AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5604
Mailing Address - Country:US
Mailing Address - Phone:402-371-4673
Mailing Address - Fax:
Practice Address - Street 1:304 N 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4091
Practice Address - Country:US
Practice Address - Phone:402-371-4673
Practice Address - Fax:402-371-7431
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4349111N00000X
NE1405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN249325000Medicaid
MNU93896Medicare UPIN
MN350003029Medicare ID - Type UnspecifiedMEDICARE ID #