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NPI Code Detail

MEDICARE: HALEY ELIZABETH OLBINA PTA

MEDICARE: HALEY ELIZABETH OLBINA PTA
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
1225200000XPhysical Therapy AssistantPTA000007008TN

General Provider Information

NPI Number : 1487119483
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ELIZABETH OLBINA PTA
Provider Business Mailing Address
First Line : 80 S PRESCOTT ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4635
Country : US
Telephone Number : 901-257-3422
Fax Number : 901-257-3423
Provider Business Practice Location Address
First Line : 80 S PRESCOTT ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4635
Country : US
Telephone Number : 901-257-3422
Fax Number : 901-257-3423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2019
Last Update Date : 02/04/2019

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Directions to “ HALEY ELIZABETH OLBINA PTA” Practice Location

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