Provider Demographics
NPI:1871255471
Name:ANDRIES, OLIVIA (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:ANDRIES
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 N 44TH ST APT 3304
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-3252
Mailing Address - Country:US
Mailing Address - Phone:937-902-9216
Mailing Address - Fax:
Practice Address - Street 1:2121 N 44TH ST APT 3304
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-3252
Practice Address - Country:US
Practice Address - Phone:937-902-9216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35087111N00000X
AZ9094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor