Provider Demographics
NPI:1063933323
Name:GARDIPEE, OLIVER
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:
Last Name:GARDIPEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W188S6323 GOLD DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-9468
Mailing Address - Country:US
Mailing Address - Phone:262-895-9802
Mailing Address - Fax:
Practice Address - Street 1:W188S6323 GOLD DR
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9468
Practice Address - Country:US
Practice Address - Phone:262-895-9802
Practice Address - Fax:262-895-9802
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health