Healthcare Provider Details

I. General information

NPI: 1275364119
Provider Name (Legal Business Name): OLIVIA BIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA ST, 80 FRIENDLY NEIGHBOR RD STE. E
CHAPMANVILLE WV
25508
US

IV. Provider business mailing address

176 OAKRIDGE ESTATES RD
DANVILLE WV
25053-8033
US

V. Phone/Fax

Practice location:
  • Phone: 304-855-9500
  • Fax:
Mailing address:
  • Phone: 304-410-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004767
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: