MEDICARE: MRS. BARBARA JO OLLIS LMT

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
1	225700000X	Massage Therapist	MT006308	TX

General Provider Information

NPI Number	:	1912189358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA JO OLLIS LMT

Provider Business Mailing Address
First Line	:	2267 TRAWOOD DR
Second Line	:	SUITE D-1
City	:	EL PASO
State	:	TX
Zip	:	79935-3027
Country	:	US
Telephone Number	:	915-592-0012
Fax Number	:	915-592-0201

Provider Business Practice Location Address
First Line	:	2267 TRAWOOD DR
Second Line	:	SUITE D-1
City	:	EL PASO
State	:	TX
Zip	:	79935-3027
Country	:	US
Telephone Number	:	915-592-0012
Fax Number	:	915-592-0201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/28/2007

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