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General NPI Number Information
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NPI Number | 1477107167
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Entity Type | Individual
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Provider Name | JEFFREY OLIVEIRA
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Gender | Male
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 3630 TENNIS CT
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-9502
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Country | US
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Telephone | 269-769-3175
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 TENNIS CT
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-9502
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Country | US
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Telephone | 269-210-5534
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Fax | 269-666-6598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501018968
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License Number State | MI
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