Individual
JEFFERY BYRON WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2610 2ND AVE, KEARNEY, NE 68847
(308) 236-7772
(308) 234-2053
Mailing address
2610 2ND AVE, KEARNEY, NE 68847
(308) 236-7772
(308) 234-2053
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
421
WY
111N00000X
Chiropractor
513
MT
111N00000X
Chiropractor
Primary
887
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36606
BLUE CROSS BLUE SHIELD
NE
05
—
47080048800
—
NE
Enumeration date
09/28/2006
Last updated
07/08/2007
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