Provider Demographics
NPI:1912148354
Name:OLCOTT, JOSHUA L (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:L
Last Name:OLCOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 BRIDLE TRL
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2788
Mailing Address - Country:US
Mailing Address - Phone:412-474-3522
Mailing Address - Fax:
Practice Address - Street 1:650 CHERRINGTON PKWY
Practice Address - Street 2:
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-4300
Practice Address - Country:US
Practice Address - Phone:412-269-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor