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General NPI Number Information
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NPI Number | 1447302146
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Entity Type | Individual
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Provider Name | ROLLAND JON HARDIES DC, ATC
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4852 S 133RD ST STE 103
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City | OMAHA
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State | NE
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Zip | 68137-1773
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Country | US
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Telephone | 402-896-6131
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Fax | 402-896-8398
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Provider Business Mailing Address
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Address Line | 135 S SCOTT ST
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City | GRETNA
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State | NE
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Zip | 68028-7888
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Country | US
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Telephone | 402-218-6282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1449
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 430
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 00599
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License Number State | IA
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