Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CO293697 | PA |
NPI | 1376142406 |
---|---|
Provider Name | Whitney Oliver |
First Address | Chester, PA 19013-3817 |
Second Address | Chester, PA 19013-3817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2020 |
Last Update Date | 20/10/2020 |