Individual
DR. OCTAVIO OLIVAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, MPH
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 522-9400
Mailing address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
R4464
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2024
Last updated
07/05/2024
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