Healthcare Provider Details
I. General information
NPI: 1588595037
Provider Name (Legal Business Name): OLSON FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
235 JUNGERMANN RD STE 209
SAINT PETERS MO
63376-5365
US
IV. Provider business mailing address
235 JUNGERMANN RD STE 209
SAINT PETERS MO
63376-5365
US
V. Phone/Fax
- Phone: 636-928-7387
- Fax:
- Phone: 636-928-7387
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYLIE
M
OLSON
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 515-729-6993