Oliver, Mark Allan

Oliver, Mark Allan is an sole proprietor health care provider with primary practice located at 111B Sanders Ln , Bluefield VA 24605-9278. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic is his primary health care specialty. Oliver, Mark Allan can be contacted via phone (276) 326-3611.

Contact Information

Primary practice address
111B Sanders Ln Bluefield VA 24605-9278
Phone: (276) 326-3611
Fax: (276) 322-2850
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 002567 West Virginia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 2305202418 Virginia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 050102053 Virginia

Profile Details

NPI number 1710185301
LBN Legal business name Oliver, Mark Allan
Credentials DPT, ATC, CSCS, CPED
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2007
Last updated Jun 27th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710185301 NPPES
West Virginia MEDICAID 0156094000

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