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NPI Code Detail

MEDICARE: OLIVIA MARINCOV PT

MEDICARE: OLIVIA MARINCOV PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT61010325WA

General Provider Information

NPI Number : 1174160568
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA MARINCOV PT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5704 E LAKE SAMMAMISH PKWY SE STE 101
Second Line :
City : ISSAQUAH
State : WA
Zip : 98029-8941
Country : US
Telephone Number : 425-270-3323
Fax Number : 425-270-3326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2019
Last Update Date : 02/04/2021

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Directions to “ OLIVIA MARINCOV PT” Practice Location

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