Provider Demographics
NPI:1881858900
Name:OLSON, DANIEL (DC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:OLSON
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 1:1785 W STATE ROUTE 89A
Mailing Address - Street 2:STE 3C
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5567
Mailing Address - Country:US
Mailing Address - Phone:928-282-7575
Mailing Address - Fax:
Practice Address - Street 1:1785 W STATE ROUTE 89A
Practice Address - Street 2:STE 3C
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5567
Practice Address - Country:US
Practice Address - Phone:928-282-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor