Provider Demographics
NPI:1295368108
Name:OLSON-GRIESS, SYDNEY (DC,DABCA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:OLSON-GRIESS
Suffix:
Gender:F
Credentials:DC,DABCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E 14TH ST STE 93
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-3200
Mailing Address - Country:US
Mailing Address - Phone:402-469-2248
Mailing Address - Fax:
Practice Address - Street 1:223 E 14TH ST STE 93
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3200
Practice Address - Country:US
Practice Address - Phone:402-469-4489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2074111N00000X
MO2020005875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty