Provider Demographics
NPI:1104535376
Name:OLIVER PAIN RELIEF AND REHAB
Entity type:Organization
Organization Name:OLIVER PAIN RELIEF AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-904-8528
Mailing Address - Street 1:1041 STERLING RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-3841
Mailing Address - Country:US
Mailing Address - Phone:703-904-8528
Mailing Address - Fax:703-904-8529
Practice Address - Street 1:1041 STERLING RD STE 106
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3841
Practice Address - Country:US
Practice Address - Phone:703-904-8528
Practice Address - Fax:703-904-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty