Provider Demographics
NPI:1730996877
Name:OLEAN FAMILY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:OLEAN FAMILY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-307-7904
Mailing Address - Street 1:2211 W STATE ST STE 122
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1951
Mailing Address - Country:US
Mailing Address - Phone:716-372-1236
Mailing Address - Fax:716-372-1915
Practice Address - Street 1:2211 W STATE ST STE 122
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1951
Practice Address - Country:US
Practice Address - Phone:716-372-1236
Practice Address - Fax:716-372-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty