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General NPI Number Information
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NPI Number | 1164552956
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Entity Type | Organization
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Legal Business Name | BOYD-OLSON CHIROPRACTIC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 224 BIRMINGHAM DR SUITE 1C
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City | CARDIFF
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State | CA
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Zip | 92007-1758
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Country | US
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Telephone | 760-943-9474
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Fax | 760-943-9631
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Provider Business Mailing Address
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Address Line | 224 BIRMINGHAM DR STE 1C
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City | CARDIFF
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State | CA
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Zip | 92007-1743
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Country | US
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Telephone | 760-943-9474
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Fax | 760-943-9631
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Authorized Official
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Title or Position | PARTNER
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Name | DAVID NEIL OLSON
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Credential | D.C.
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Telephone | 760-943-9474
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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 | DC12006
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License Number State | CA
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