Provider Demographics
NPI:1003686916
Name:OLIVER, MARK R
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:OLIVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 SUMMERHILL DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8384
Mailing Address - Country:US
Mailing Address - Phone:717-856-8707
Mailing Address - Fax:
Practice Address - Street 1:687 SUMMERHILL DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8384
Practice Address - Country:US
Practice Address - Phone:717-856-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications