Provider Demographics
NPI:1477020436
Name:OLIVER, CHASE MACKIN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:MACKIN
Last Name:OLIVER
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 1:540 OAK CENTRE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4767
Mailing Address - Country:US
Mailing Address - Phone:210-493-9119
Mailing Address - Fax:210-493-7923
Practice Address - Street 1:540 OAK CENTRE DR STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3936
Practice Address - Country:US
Practice Address - Phone:210-493-9119
Practice Address - Fax:210-493-7923
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor