Provider Demographics
NPI:1285330100
Name:HEALEY, OLIVIA MAE (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:MAE
Last Name:HEALEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 WALNUT RIDGE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9335
Mailing Address - Country:US
Mailing Address - Phone:262-745-2632
Mailing Address - Fax:
Practice Address - Street 1:925 WALNUT RIDGE DR STE 250
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9335
Practice Address - Country:US
Practice Address - Phone:262-500-4311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6206-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor