Healthcare Provider Details

I. General information

NPI: 1558353771
Provider Name (Legal Business Name): SHELLEY K OLREE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20417 STATE ST
ONAWAY MI
49765-8692
US

IV. Provider business mailing address

PO BOX 74
ONAWAY MI
49765-0074
US

V. Phone/Fax

Practice location:
  • Phone: 989-733-2800
  • Fax: 989-733-7571
Mailing address:
  • Phone: 989-733-2800
  • Fax: 989-733-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301005890
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: