Healthcare Provider Details

I. General information

NPI: 1083744528
Provider Name (Legal Business Name): JOHN B OLENIK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 W AURORA RD
SAGAMORE HILLS OH
44067-2160
US

IV. Provider business mailing address

367 W AURORA RD
SAGAMORE HILLS OH
44067-2160
US

V. Phone/Fax

Practice location:
  • Phone: 330-468-2555
  • Fax: 330-468-5225
Mailing address:
  • Phone: 330-468-2555
  • Fax: 330-468-5225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2002
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5192
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: