Individual
JOSE ENRIQUE OLIVENCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2100 MILLVALE RD, LOUISVILLE, KY 40205-1604
(502) 451-0990
Mailing address
206 HIDDEN OAK PL, LOUISVILLE, KY 40222-4866
(502) 608-5978
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
131789
KY
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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