Most Relevant Information
Provider Data
| NPI Number: | 1003803750 |
| Provider Name: | LISA M OLIVERO |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MA-31267 |
Most Important Dates
| Enumeration Date: | 09/27/2005 |
| Last Updated: | 07/09/2007 |
Provider Practice Location
2 MARJORIE TRL
ORMOND BEACH
FL
321748501
Practice Location Phone/Fax
| Phone: | 3866737904 |
| Fax: | 3866737904 |
Provider Mailing Location
2 MARJORIE TRL
ORMOND BEACH
FL
321748501
Provider Mailing Phone/Fax
| Phone: | 3866737904 |
| Fax: | 3866737904 |