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General NPI Number Information
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NPI Number | 1750380366
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Entity Type | Organization
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Legal Business Name | HEALTH CHOICE OF OLIVIA
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1325 W LINCOLN AVE
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City | OLIVIA
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State | MN
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Zip | 56277-1272
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Country | US
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Telephone | 320-523-1253
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Fax | 320-523-1572
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Provider Business Mailing Address
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Address Line | 1325 W LINCOLN AVE
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City | OLIVIA
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State | MN
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Zip | 56277-1272
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Country | US
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Telephone | 320-523-1253
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Fax | 320-523-1572
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Authorized Official
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Title or Position | DR. ROBIDEA- PRESIDENT
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Name | MS. JENNIFER ELIZABETH ROBIDEAU
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Credential | D.C.
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Telephone | 320-523-1253
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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 | 4314
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License Number State | MN
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