Provider Demographics
NPI:1841996360
Name:MIKULA, OLIVIA NAOMI (PT, DPT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:NAOMI
Last Name:MIKULA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:NAOMI
Other - Last Name:LINDSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:310 RODI RD STE 260
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 RODI RD STE 260
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3318
Practice Address - Country:US
Practice Address - Phone:412-871-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist