Provider Demographics
NPI:1922995299
Name:VRANICH, OLIVIA GRACE (ATC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:GRACE
Last Name:VRANICH
Suffix:
Gender:X
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 WOLGEMUTH DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-6200
Mailing Address - Country:US
Mailing Address - Phone:717-490-3632
Mailing Address - Fax:
Practice Address - Street 1:1900 W OLNEY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-1199
Practice Address - Country:US
Practice Address - Phone:609-661-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer