Provider Demographics
NPI:1144614512
Name:OLLHOFT, TIFFANY SIRMON (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:SIRMON
Last Name:OLLHOFT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:MARIE
Other - Last Name:SIRMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:300 FAULKNER DR
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-2771
Mailing Address - Country:US
Mailing Address - Phone:251-937-9881
Mailing Address - Fax:251-937-9804
Practice Address - Street 1:300 FAULKNER DR
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-2771
Practice Address - Country:US
Practice Address - Phone:251-937-9881
Practice Address - Fax:251-937-9804
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA5995225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant