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NPI Code Detail

MEDICARE: MS. HEATHER MARIE OLEX ATC

MEDICARE: MS. HEATHER MARIE OLEX ATC
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
12255A2300XAthletic TrainerRT005942PA

General Provider Information

NPI Number : 1497231088
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER MARIE OLEX ATC
Provider Business Mailing Address
First Line : 125 W 5TH AVE APT 2
Second Line :
City : CONSHOHOCKEN
State : PA
Zip : 19428-1600
Country : US
Telephone Number : 609-558-0025
Fax Number :
Provider Business Practice Location Address
First Line : 450 S EASTON RD
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-3215
Country : US
Telephone Number : 215-572-2848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 07/17/2018

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Directions to “ MS. HEATHER MARIE OLEX ATC” Practice Location

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