Provider Demographics
NPI:1851701544
Name:OLIVO, MEGAN MARIE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:OLIVO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 E MOREHEAD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2889
Mailing Address - Country:US
Mailing Address - Phone:704-348-4488
Mailing Address - Fax:704-348-4496
Practice Address - Street 1:1228 E MOREHEAD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2889
Practice Address - Country:US
Practice Address - Phone:704-348-4488
Practice Address - Fax:704-348-4496
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist