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General NPI Number Information
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NPI Number | 1053134999
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Entity Type | Organization
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Legal Business Name | OLSEN ELITE CHIROPRACTIC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 806 E MAIN ST
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City | TREMONTON
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State | UT
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Zip | 84337-6733
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Country | US
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Telephone | 435-291-5060
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Fax |
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Provider Business Mailing Address
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Address Line | 806 E MAIN ST
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City | TREMONTON
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State | UT
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Zip | 84337-6733
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Country | US
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Telephone | 435-291-5060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JARED OLSEN
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Credential | D.C.
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Telephone | 435-230-1456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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