Provider Demographics
NPI:1952779605
Name:OLIVE ME CHIROPRACTIC, CORPORATION
Entity Type:Organization
Organization Name:OLIVE ME CHIROPRACTIC, CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ZGIA
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:HOFFPAUIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-340-3013
Mailing Address - Street 1:3785 LEXINGTON AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2937
Mailing Address - Country:US
Mailing Address - Phone:651-340-3013
Mailing Address - Fax:
Practice Address - Street 1:3785 LEXINGTON AVE N STE 100
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55126-2937
Practice Address - Country:US
Practice Address - Phone:651-340-3013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty