Provider Demographics
NPI: | 1780351320 |
---|---|
Name: | VOITHOFER CHIROPRACTIC & ACCIDENT REHABILITATION LLC |
Entity type: | Organization |
Organization Name: | VOITHOFER CHIROPRACTIC & ACCIDENT REHABILITATION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIROPRACTOR/OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BRYAN |
Authorized Official - Middle Name: | THOMAS |
Authorized Official - Last Name: | VOITHOFER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 402-676-9544 |
Mailing Address - Street 1: | 5318 S. 107TH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | OMAHA |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68127-2923 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-676-9544 |
Mailing Address - Fax: | 402-505-7128 |
Practice Address - Street 1: | 16850 FRANCES ST STE 104 |
Practice Address - Street 2: | |
Practice Address - City: | OMAHA |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68130-2640 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-676-9544 |
Practice Address - Fax: | 877-478-4366 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-23 |
Last Update Date: | 2024-05-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |