Provider Demographics
NPI:1447755632
Name:STENSRUD, OLIVIA ERIN (DC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ERIN
Last Name:STENSRUD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-3026
Mailing Address - Country:US
Mailing Address - Phone:612-874-1313
Mailing Address - Fax:
Practice Address - Street 1:2112 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-3026
Practice Address - Country:US
Practice Address - Phone:612-874-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor