Provider Demographics
NPI:1477648210
Name:OLIEN, DANIEL R (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:OLIEN
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 1:706 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-1440
Mailing Address - Country:US
Mailing Address - Phone:715-246-2390
Mailing Address - Fax:715-246-7002
Practice Address - Street 1:706 W 4TH ST
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1440
Practice Address - Country:US
Practice Address - Phone:715-246-2390
Practice Address - Fax:715-246-7002
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3943-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000035990Medicare PIN
WIU96834Medicare UPIN