Provider Demographics
NPI:1740250646
Name:ROHLK, RYAN KNOX (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:KNOX
Last Name:ROHLK
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 1:1611 OKOBOJI AVE
Mailing Address - Street 2:P.O. BOX 291
Mailing Address - City:MILFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51351-1258
Mailing Address - Country:US
Mailing Address - Phone:712-338-2127
Mailing Address - Fax:712-338-2178
Practice Address - Street 1:1611 OKOBOJI AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IA
Practice Address - Zip Code:51351-1258
Practice Address - Country:US
Practice Address - Phone:712-338-2127
Practice Address - Fax:712-338-2178
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0292607Medicaid
IA0292607Medicaid