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NPI Code Detail

MEDICARE: MS. MARIANNE CECELIA OLIVER PT

MEDICARE: MS. MARIANNE CECELIA OLIVER PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist0871OH

General Provider Information

NPI Number : 1194794479
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIANNE CECELIA OLIVER PT
Provider Business Mailing Address
First Line : 5462 BANEBERRY AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-7398
Country : US
Telephone Number : 614-326-0347
Fax Number :
Provider Business Practice Location Address
First Line : 1151 COLLEGE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43209-2827
Country : US
Telephone Number : 614-559-0229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/08/2007

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