Provider Demographics
NPI:1861706426
Name:OLEARY CHIROPRACTIC HEALING AND WELLNESS
Entity type:Organization
Organization Name:OLEARY CHIROPRACTIC HEALING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:O'LEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-607-3142
Mailing Address - Street 1:173 LONG RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1255
Mailing Address - Country:US
Mailing Address - Phone:636-530-1212
Mailing Address - Fax:636-536-4221
Practice Address - Street 1:2077 FLORAL DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6876
Practice Address - Country:US
Practice Address - Phone:314-607-3142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010016307261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care