Custom Chiropractic & Wellness Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009664 Issued in MI

Legal business name

CUSTOM CHIROPRACTIC & WELLNESS INC

Practice address

3631 S Baldwin Rd
Lake Orion, MI 48359-1506

Phone

(248) 391-5400

Fax

(248) 391-5404

NPI assigned

Sep 28, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jason Olafsson, DCNPI 1568763597

Title

Owner

Phone

(248) 391-5400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason T Olafsson, DC

  • Chiropractor
  • Lake Orion, MI
  • NPI 1568763597
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1285985374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591506",
            "telephone_number": "248-391-5400",
            "fax_number": "248-391-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 S BALDWIN RD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483591506",
            "telephone_number": "248-391-5400",
            "fax_number": "248-391-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM CHIROPRACTIC & WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "OLAFSSON",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-391-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950F39332",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crittenton Medical Equipment, LLC
• Barbara Crone, CNM, CNP
• Shawna Susanne Cuda
• Cuddle & Care Lactation, LLC
• Rebecca Jo Culvey, PTA
• Sunil Kumar Das, MD
• Carolyn Mei Davis
• Kelsie Marie Davis, DPT
• Krystal Laura Dayton, MSW,CSW
• Kennedy Riley Dean

• Chiropractor in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.