Provider Demographics
NPI:1679618193
Name:OLIEN FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:OLIEN FAMILY CHIROPRACTIC LLC
Other - Org Name:OLIEN & READ FAMILY CHIROPRACTIC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-246-2390
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:715-246-7830
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:715-246-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3943-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1477648210OtherINDIVIDUAL NPI NUMBER
WI1477648210OtherINDIVIDUAL NPI NUMBER
WI000035990Medicare PIN