Provider Demographics
NPI:1063893477
Name:TERRELL, OLIVIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:TERRELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 HERITAGE CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3553
Mailing Address - Country:US
Mailing Address - Phone:828-393-5168
Mailing Address - Fax:865-951-7273
Practice Address - Street 1:68 BREEZY VALLEY CONNECTOR
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3054
Practice Address - Country:US
Practice Address - Phone:828-393-5168
Practice Address - Fax:865-951-7273
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.015461225100000X
GAPT016198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist