Provider Demographics
NPI:1093579542
Name:ISENHOWER, OLIVIA (DC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ISENHOWER
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 1:6005 W GRAPHIC RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-8593
Mailing Address - Country:US
Mailing Address - Phone:479-883-1004
Mailing Address - Fax:
Practice Address - Street 1:6005 W GRAPHIC RD
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:AR
Practice Address - Zip Code:72921-8593
Practice Address - Country:US
Practice Address - Phone:479-883-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor