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General NPI Number Information
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NPI Number | 1710185301
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Entity Type | Individual
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Provider Name | MARK ALLAN OLIVER DPT, ATC, CSCS
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Gender | Male
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 432 E MAIN ST STE A-1
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City | ABINGDON
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State | VA
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Zip | 24210-3488
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Country | US
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Telephone | 276-608-4468
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Fax | 276-240-1010
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Provider Business Mailing Address
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Address Line | 432 E MAIN ST STE A-1
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City | ABINGDON
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State | VA
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Zip | 24210-3488
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Country | US
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Telephone | 276-608-4468
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Fax | 276-240-1010
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 002567
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 050102053
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305202418
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License Number State | VA
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