Provider Demographics
NPI:1447302146
Name:HARDIES, ROLLAND JON (DC, ATC)
Entity type:Individual
Prefix:DR
First Name:ROLLAND
Middle Name:JON
Last Name:HARDIES
Suffix:
Gender:M
Credentials:DC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-7888
Mailing Address - Country:US
Mailing Address - Phone:402-218-6282
Mailing Address - Fax:
Practice Address - Street 1:4852 S 133RD ST STE 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1773
Practice Address - Country:US
Practice Address - Phone:402-896-6131
Practice Address - Fax:402-896-8398
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1449111N00000X
NE4302255A2300X
IA005992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer