| Doctor Name: | DR. DOMINICK OLIVO |
| NPI Number: | 1023005378 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 151 |
| Business Practice Address: | 702 N 13th St Artesia, NM - 882101166 |
| Business Phone Number: | 5757483333 |
| Business Fax Number: | 5757488305 |
| Mailing Address: | 702 N 13th St, ARTESIA |
| State: | NM |
| Postal Code: | 882101166 |
| Phone Number: | 5757483333 |
| Fax Number: | 5757488305 |
| NPI Enumeration Date: | 10/03/2005 |
| NPI Last Update Date: | 05/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 151 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |