Provider Demographics
NPI:1124379896
Name:OLSON CHIROPRACTIC & REHAB, INC
Entity Type:Organization
Organization Name:OLSON CHIROPRACTIC & REHAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-231-1900
Mailing Address - Street 1:7920 BELT LINE RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-8145
Mailing Address - Country:US
Mailing Address - Phone:972-231-1900
Mailing Address - Fax:888-501-3069
Practice Address - Street 1:7920 BELT LINE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-8145
Practice Address - Country:US
Practice Address - Phone:972-231-1900
Practice Address - Fax:888-501-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty