Provider Demographics
NPI:1790861094
Name:OLDING, BRYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:OLDING
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 1:679 N VANDEMARK RD
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-3552
Mailing Address - Country:US
Mailing Address - Phone:937-497-8779
Mailing Address - Fax:937-497-8779
Practice Address - Street 1:679 N VANDEMARK RD
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-3552
Practice Address - Country:US
Practice Address - Phone:937-497-8779
Practice Address - Fax:937-497-8779
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor