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General NPI Number Information
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NPI Number | 1467642728
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Entity Type | Organization
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Legal Business Name | OLSON BROS. CHIROPRACTIC PA
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 2400 COUNTY ROAD D W SUITE 101
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City | SAINT PAUL
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State | MN
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Zip | 55112-7564
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Country | US
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Telephone | 651-633-0155
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Fax | 651-604-2935
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Provider Business Mailing Address
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Address Line | 2400 COUNTY ROAD D W SUITE 101
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City | SAINT PAUL
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State | MN
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Zip | 55112-7564
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Country | US
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Telephone | 651-633-0155
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Fax | 651-604-2935
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TERESA ANN NELSON
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Credential |
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Telephone | 651-633-0155
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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 | 427
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License Number State | MN
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