Healthcare Provider Details

I. General information

NPI: 1316902893
Provider Name (Legal Business Name): DAVID M OLIVER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E MICHIGAN AVE
SALINE MI
48176
US

IV. Provider business mailing address

1600 MONTCLAIR PLACE
ANN ARBOR MI
42104
US

V. Phone/Fax

Practice location:
  • Phone: 734-944-1005
  • Fax: 734-944-1303
Mailing address:
  • Phone: 734-913-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7961
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: