Provider Demographics
NPI:1730456419
Name:VANROEKEL, JAMISON DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMISON
Middle Name:DEAN
Last Name:VANROEKEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 S 107TH AVE
Mailing Address - Street 2:STE 109
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4719
Mailing Address - Country:US
Mailing Address - Phone:402-835-5885
Mailing Address - Fax:402-835-5995
Practice Address - Street 1:920 S 107TH AVE
Practice Address - Street 2:STE 109
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4719
Practice Address - Country:US
Practice Address - Phone:402-835-5885
Practice Address - Fax:402-835-5995
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007468111N00000X
NE1811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor