Provider Demographics
NPI:1710191598
Name:DR. TRAVIS OLLER
Entity Type:Organization
Organization Name:DR. TRAVIS OLLER
Other - Org Name:DOWNTOWN CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:785-233-2300
Mailing Address - Street 1:117 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603-3801
Mailing Address - Country:US
Mailing Address - Phone:785-233-2300
Mailing Address - Fax:785-233-2320
Practice Address - Street 1:117 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3801
Practice Address - Country:US
Practice Address - Phone:785-233-2300
Practice Address - Fax:785-233-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660094OtherBCBS
U83491Medicare UPIN
KS660094OtherBCBS