Provider Demographics
NPI:1932146057
Name:ROLLMAN, CHRISTINE A (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:ROLLMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13220 CALLUM DR
Mailing Address - Street 2:STE 2
Mailing Address - City:WAVERLY
Mailing Address - State:NE
Mailing Address - Zip Code:68462-2561
Mailing Address - Country:US
Mailing Address - Phone:402-786-0257
Mailing Address - Fax:
Practice Address - Street 1:13220 CALLUM DR
Practice Address - Street 2:STE 2
Practice Address - City:WAVERLY
Practice Address - State:NE
Practice Address - Zip Code:68462-2561
Practice Address - Country:US
Practice Address - Phone:402-786-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009819111N00000X
TX13271111N00000X
NE1730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ20-1675535OtherTAX ID NUMBER