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General NPI Number Information
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NPI Number | 1871485094
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Entity Type | Organization
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Legal Business Name | OLIVEIRA SPORT AND ORTHOPEDIC PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 157 N 5TH AVE
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City | OAKDALE
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State | CA
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Zip | 95361-3128
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Country | US
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Telephone | 209-844-5012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 337
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City | OAKDALE
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State | CA
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Zip | 95361-0337
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Country | US
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Telephone | 209-535-3078
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Fax |
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Authorized Official
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Title or Position | CEO/PHYSICAL THERAPIST
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Name | DR. JASON OLIVEIRA
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Credential | PT, DPT
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Telephone | 209-535-3078
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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 |
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License Number State |
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