Healthcare Provider Details

I. General information

NPI: 1225088628
Provider Name (Legal Business Name): RICHARD E. OLFF D.C., F.A.C.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E MARKET ST
JONESTOWN PA
17038-9619
US

IV. Provider business mailing address

PO BOX 657
JONESTOWN PA
17038-0657
US

V. Phone/Fax

Practice location:
  • Phone: 717-865-6623
  • Fax: 717-865-3382
Mailing address:
  • Phone: 717-865-6623
  • Fax: 717-865-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC001466L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: