Healthcare Provider Details

I. General information

NPI: 1205068764
Provider Name (Legal Business Name): OLGA WEEKS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 09/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S CONGRESS ST
YORK SC
29745-1836
US

IV. Provider business mailing address

803 HERRONS FERRY RD
ROCK HILL SC
29730-4593
US

V. Phone/Fax

Practice location:
  • Phone: 803-684-0035
  • Fax:
Mailing address:
  • Phone: 615-351-4764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6627
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13594
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: