Provider Demographics
NPI:1225041767
Name:OLIVAR, LEANNA CRISTINA (ATC)
Entity Type:Individual
Prefix:MS
First Name:LEANNA
Middle Name:CRISTINA
Last Name:OLIVAR
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 1:3880 E BRIGHT VIEW ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706-4988
Mailing Address - Country:US
Mailing Address - Phone:520-393-8374
Mailing Address - Fax:
Practice Address - Street 1:1 NATIONAL CHAMPIONSHIP DR
Practice Address - Street 2:MCKALE MEMORIAL CENTER #N108
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0096
Practice Address - Country:US
Practice Address - Phone:520-621-4674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ05082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer