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OLSEN CHIROPRACTIC & PERFORMANCE ENHANCEMENT

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Company Details

Name: OLSEN CHIROPRACTIC & PERFORMANCE ENHANCEMENT
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Inactive-Cancelled
Date of registration: 04 May 2000 (25 years ago)
Entity Number: 119114
Place of Formation: IDAHO
File Number: 0000119114
ZIP code: 83705
County: Ada County
Mailing Address: 2290 S CHALLENGER LN #101 BOISE, ID 83705

National Provider Identifier

NPI Number:
1912221938
Certification Date:
2023-07-21

Authorized Person:

Name:
NATHAN DEE OLSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
Yes

Contacts:

Fax:
8024619130

Filing

Filing Name Filing Number Filing date
Cancellation of Certificate of Assumed Business Name 0000722307 2007-05-23
Initial Filing 0000119114 2000-05-04

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State