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General NPI Number Information
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NPI Number | 1720793367
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Entity Type | Individual
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Provider Name | KYLE OLLIGES OTD, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 01/18/2023
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 5 NURSING HOME DR
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City | CLAREMONT
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State | NH
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Zip | 03743-7344
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Country | US
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Telephone | 603-542-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 4920 MID DR
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City | LOUISVILLE
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State | KY
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Zip | 40272-3264
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3912
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License Number State | NH
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