Provider Demographics
NPI:1447429360
Name:OLSON CHIROPRACTIC WELLNESS CENTER
Entity Type:Organization
Organization Name:OLSON CHIROPRACTIC WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:V
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-322-8885
Mailing Address - Street 1:1693 SW CHANDLER AVE
Mailing Address - Street 2:ST 130
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3236
Mailing Address - Country:US
Mailing Address - Phone:541-322-8885
Mailing Address - Fax:541-322-6800
Practice Address - Street 1:1693 SW CHANDLER AVE
Practice Address - Street 2:ST 130
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3236
Practice Address - Country:US
Practice Address - Phone:541-322-8885
Practice Address - Fax:541-322-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty