Provider Demographics
NPI:1164041786
Name:SZALLAI, OLIVIA (ATC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SZALLAI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 ALUMNI DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40506-0006
Mailing Address - Country:US
Mailing Address - Phone:908-307-3802
Mailing Address - Fax:
Practice Address - Street 1:295 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40506-0006
Practice Address - Country:US
Practice Address - Phone:908-307-3802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT15942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer