Basic Information
Provider Information
NPI: 1174902464
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLIVEIRA
FirstName: ANDREA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHWAB
OtherFirstName: ANDREA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: P.T.
OtherLastNameType: 1
Mailing Information
Address1: 8670 WOLFF CT
Address2: BUILDING 8, SUITE 115
City: WESTMINSTER
State: CO
PostalCode: 800316956
CountryCode: US
TelephoneNumber: 3036501700
FaxNumber:  
Practice Location
Address1: 8670 WOLFF CT
Address2: BUILDING 8, SUITE 115
City: WESTMINSTER
State: CO
PostalCode: 800316956
CountryCode: US
TelephoneNumber: 3036501700
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/20/2015
LastUpdateDate: 05/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL0012794COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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