Provider Demographics
NPI:1821042839
Name:O'DONNELL, JULIET RENEE (DC)
Entity Type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:RENEE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:JULIET
Other - Middle Name:RENEE
Other - Last Name:KOLB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5521 NW 86TH STREET
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131
Mailing Address - Country:US
Mailing Address - Phone:515-252-8668
Mailing Address - Fax:515-270-2457
Practice Address - Street 1:5521 NW 86TH STREET
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131
Practice Address - Country:US
Practice Address - Phone:515-252-8668
Practice Address - Fax:515-270-2457
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007205111N00000X
MN4769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor