Healthcare Provider Details

I. General information

NPI: 1871043281
Provider Name (Legal Business Name): OLIVIA NEUMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 FORT EVANS RD NE STE B
LEESBURG VA
20176-4497
US

IV. Provider business mailing address

3300 RIVERMONT AVE
LYNCHBURG VA
24503-2030
US

V. Phone/Fax

Practice location:
  • Phone: 571-367-7960
  • Fax:
Mailing address:
  • Phone: 434-200-5032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305210630
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: