Healthcare Provider Details

I. General information

NPI: 1417880030
Provider Name (Legal Business Name): JARED ROHLF DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15602 WHITING CIR STE 130
BENNINGTON NE
68007-3355
US

IV. Provider business mailing address

PO BOX 34669
OMAHA NE
68134-0669
US

V. Phone/Fax

Practice location:
  • Phone: 402-915-6773
  • Fax: 402-915-6775
Mailing address:
  • Phone: 402-932-6791
  • Fax: 402-614-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4929
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: