Provider Demographics
NPI:1790869923
Name:ROHRICK, THOMAS THEODORE II (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:THEODORE
Last Name:ROHRICK
Suffix:II
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 1:21 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2000
Mailing Address - Country:US
Mailing Address - Phone:308-635-8190
Mailing Address - Fax:308-635-3226
Practice Address - Street 1:21 E 20TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2000
Practice Address - Country:US
Practice Address - Phone:308-635-8190
Practice Address - Fax:308-635-3226
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1014111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE9747OtherBCBS
NE911781578-00Medicaid
NE350043968OtherRR MEDICARE
NE271160Medicare ID - Type Unspecified
NE911781578-00Medicaid