Provider Demographics
NPI:1659379808
Name:OLREE, RICHARD NEAL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEAL
Last Name:OLREE
Suffix:JR
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:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-0550
Mailing Address - Country:US
Mailing Address - Phone:989-742-4242
Mailing Address - Fax:989-742-4222
Practice Address - Street 1:311 STATE STREET
Practice Address - Street 2:
Practice Address - City:HILLMAN
Practice Address - State:MI
Practice Address - Zip Code:49746
Practice Address - Country:US
Practice Address - Phone:989-742-4242
Practice Address - Fax:989-742-4222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F05000OtherBCBS OF MICHIGAN
MI2862169Medicaid
T33292Medicare UPIN
MI950F05000OtherBCBS OF MICHIGAN