Provider Demographics
NPI:1235492968
Name:OLBERDING, COLIN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:LEE
Last Name:OLBERDING
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 1:445 N JEFF DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1629
Mailing Address - Country:US
Mailing Address - Phone:770-739-2825
Mailing Address - Fax:
Practice Address - Street 1:2677 WILLAKENZIE RD STE 8
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4873
Practice Address - Country:US
Practice Address - Phone:541-543-5032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor