Provider Demographics
NPI:1881121390
Name:OLIVADOTI, JOSEPH (ATC, LAT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:OLIVADOTI
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 SPLIT OAK LN APT A
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5223
Mailing Address - Country:US
Mailing Address - Phone:908-675-2809
Mailing Address - Fax:
Practice Address - Street 1:365 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173-5302
Practice Address - Country:US
Practice Address - Phone:804-289-8719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer