Provider Demographics
NPI:1184750994
Name:OLIVEWOOD MEADOWS CHIROPRACTIC
Entity type:Organization
Organization Name:OLIVEWOOD MEADOWS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-726-4646
Mailing Address - Street 1:1190 OLIVEWOOD DR
Mailing Address - Street 2:STE. D
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-1256
Mailing Address - Country:US
Mailing Address - Phone:209-726-4646
Mailing Address - Fax:209-726-4630
Practice Address - Street 1:1190 OLIVEWOOD DR
Practice Address - Street 2:STE. D
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1256
Practice Address - Country:US
Practice Address - Phone:209-726-4646
Practice Address - Fax:209-726-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ24682ZMedicare ID - Type UnspecifiedPROVIDER NUMBER
CADC026761Medicare ID - Type UnspecifiedMEDICARE GRP. #
CAU82608Medicare UPIN