Gary L Olaveson in Idaho Falls - Chiropractor
Gary L Olaveson - NPI 1336163476
Gary L Olaveson is a Chiropractor in Idaho Falls, Idaho. Gary L Olaveson practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Gary L Olaveson is 1336163476. The last update date is 2017-09-14.
Gary L Olaveson's current location address is 645 S Woodruff Ave, Idaho Falls, Idaho. You can contact this provider via phone number 2085529886 and fax number 2085529843. The mailing address for Gary L Olaveson is 645 S Woodruff Ave, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary L Olaveson |
|---|---|
| Address | 645 S Woodruff Ave, Idaho Falls, Idaho |
| Phone Number | 2085529886 |
| Fax Number | 2085529843 |
| Sole Proprietor | N |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1336163476 |
|---|---|
| Provider Enumeration Date | 2006-07-26 |
| Last Updated Date | 2017-09-14 |
Provider Mailing Address Detail
| Address | 645 S Woodruff Ave |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834015596 |
| Phone Number | 2085529886 |
| Fax Number | 2085529843 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | CHIA871 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10025345 | ID | BLUE SHIELD | |
| C4546 | ID | BLUE CROSS |
Post Comment/ Review Below
What is the unique identifier code issued to Gary L Olaveson by the Centers for Medicare & Medicaid Services?
The Gary L Olaveson has been assigned the NPI (National Provider Identifier) 1336163476. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Gary L Olaveson?
The Gary L Olaveson is physically situated at 645 S Woodruff Ave, in the city of Idaho Falls, state of ID, with the postal code 834015596.
What is the Gary L Olaveson's specialty and taxonomy code?
The Gary L Olaveson's specialty is Chiropractor, and the corresponding taxonomy code is 111N00000X.
When was the Gary L Olaveson's 1336163476 issued?
The Gary L Olaveson's 1336163476 was issued on 2006-07-26.
As of what date were the details related to Gary L Olaveson most recently updated or revised?
The information pertaining to Gary L Olaveson, including its address, specialty, and other relevant details, was last updated or revised on 2017-09-14.