Healthcare Provider Details

I. General information

NPI: 1235246901
Provider Name (Legal Business Name): PHILIP J OLVERD D.C., R.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MOUNT LEBANON BLVD
PITTSBURGH PA
15234-1503
US

IV. Provider business mailing address

400 MOUNT LEBANON BLVD
PITTSBURGH PA
15234-1503
US

V. Phone/Fax

Practice location:
  • Phone: 412-341-4344
  • Fax: 412-341-4339
Mailing address:
  • Phone: 412-341-4344
  • Fax: 412-341-4339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005043L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: