Provider Demographics
NPI:1083707343
Name:OLSZEWSKI, LISA S (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:S
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COMMERCE PARK DR
Mailing Address - Street 2:STE 200
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1620
Mailing Address - Country:US
Mailing Address - Phone:734-433-9564
Mailing Address - Fax:734-433-9574
Practice Address - Street 1:1600 COMMERCE PARK DR
Practice Address - Street 2:STE 200
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1620
Practice Address - Country:US
Practice Address - Phone:734-433-9564
Practice Address - Fax:734-433-9574
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008797111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP08830001Medicare ID - Type Unspecified