Healthcare Provider Details

I. General information

NPI: 1457279887
Provider Name (Legal Business Name): JOE OLSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MAIN ST STE 120
DELAFIELD WI
53018-1447
US

IV. Provider business mailing address

76500 WEST RD
BUTTERNUT WI
54514-9150
US

V. Phone/Fax

Practice location:
  • Phone: 262-337-9645
  • Fax:
Mailing address:
  • Phone: 715-560-3170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6418-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: