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General NPI Number Information
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NPI Number | 1740518836
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Entity Type | Individual
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Provider Name | TERESA OLIVER LMT
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Gender | Female
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 1144 TALLEVAST RD STE 101
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City | SARASOTA
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State | FL
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Zip | 34243-6213
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Country | US
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Telephone | 941-359-9090
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Fax | 941-360-1595
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Provider Business Mailing Address
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Address Line | 2606 11TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-4017
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Country | US
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Telephone | 413-374-9376
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA51146
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License Number State | FL
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