Provider Demographics
NPI:1053451427
Name:OLSEN, JOHN PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:OLSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 WOODDALE LN # C
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-1109
Mailing Address - Country:US
Mailing Address - Phone:615-428-1076
Mailing Address - Fax:
Practice Address - Street 1:953 MAIN ST
Practice Address - Street 2:SUITE 109
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3623
Practice Address - Country:US
Practice Address - Phone:615-428-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor