Provider Demographics
NPI:1134551310
Name:OLSON CHIROPRACTIC HEALTH CENTER PLLC
Entity type:Organization
Organization Name:OLSON CHIROPRACTIC HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-289-1015
Mailing Address - Street 1:1510 SW ORALABOR RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7079
Mailing Address - Country:US
Mailing Address - Phone:515-289-1015
Mailing Address - Fax:515-289-3775
Practice Address - Street 1:1510 SW ORALABOR RD
Practice Address - Street 2:SUITE B
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7079
Practice Address - Country:US
Practice Address - Phone:515-289-1015
Practice Address - Fax:515-289-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007290261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service