Provider Demographics
NPI:1467828681
Name:DEYSHER, OLIVIA JULIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:JULIE
Last Name:DEYSHER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:OLIVIA
Other - Middle Name:JULIE
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:42 BICK RD
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-9741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 STATE HILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1993
Practice Address - Country:US
Practice Address - Phone:484-628-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7860225100000X
PAPT025739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist