Provider Demographics
NPI:1225088628
Name:OLFF, RICHARD E (DC, FACO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:OLFF
Suffix:
Gender:M
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:JONESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17038-0657
Mailing Address - Country:US
Mailing Address - Phone:717-865-6623
Mailing Address - Fax:717-865-3382
Practice Address - Street 1:10 E MARKET ST
Practice Address - Street 2:
Practice Address - City:JONESTOWN
Practice Address - State:PA
Practice Address - Zip Code:17038-9619
Practice Address - Country:US
Practice Address - Phone:717-865-6623
Practice Address - Fax:717-865-3382
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001466L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016066650001Medicaid
PA169861Medicare PIN
PAT29882Medicare UPIN