Provider Demographics
NPI:1073362695
Name:RAWLYK, OLIVIA MAE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MAE
Last Name:RAWLYK
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 1:208 FIRE MONUMENT RD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55037-8310
Mailing Address - Country:US
Mailing Address - Phone:877-758-6328
Mailing Address - Fax:320-336-0036
Practice Address - Street 1:208 FIRE MONUMENT RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:MN
Practice Address - Zip Code:55037-8310
Practice Address - Country:US
Practice Address - Phone:877-758-6328
Practice Address - Fax:320-336-0036
Is Sole Proprietor?:No
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program