Provider Demographics
NPI:1396241808
Name:OLSON, ELIZABETH ANN (DC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:OLSON
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 1:7576 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:PRATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:14873-9783
Mailing Address - Country:US
Mailing Address - Phone:315-294-2268
Mailing Address - Fax:
Practice Address - Street 1:7576 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:PRATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:14873-9783
Practice Address - Country:US
Practice Address - Phone:315-294-2268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013067111N00000X
MN6488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor