Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 38MC00190700 | NJ |
NPI | 1285788497 |
---|---|
Provider Name | Dr. Thomas D Oliver |
First Address | Moorestown, NJ 08057-1625 |
Second Address | Moorestown, NJ 08057-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |