Provider Demographics
NPI:1912148354
Name:OLCOTT, JOSHUA L (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:L
Last Name:OLCOTT
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 W LEMON ST
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-3855
Mailing Address - Country:US
Mailing Address - Phone:352-633-1048
Mailing Address - Fax:
Practice Address - Street 1:113 W LEMON ST
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3855
Practice Address - Country:US
Practice Address - Phone:352-633-1048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor