Provider Demographics
NPI:1639781040
Name:POWER, OLIVIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:POWER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:HOEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2019 SETTLE CIR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-2243
Mailing Address - Country:US
Mailing Address - Phone:770-380-7506
Mailing Address - Fax:
Practice Address - Street 1:6001 PROFESSIONAL PKWY STE 1040
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5632
Practice Address - Country:US
Practice Address - Phone:770-489-3513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist