Individual
MR. CARLOS ANTONIO OLIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
9505 ELVIN AVE NE, ALBUQUERQUE, NM 87112-2913
(505) 681-9004
Mailing address
9505 ELVIN AVE NE, ALBUQUERQUE, NM 87112-2913
(505) 681-9004
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1505
FL
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
12/09/2005
Last updated
05/16/2020
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