Provider Demographics
NPI:1912189358
Name:OLLIS, BARBARA JO (LMT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JO
Last Name:OLLIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2267 TRAWOOD DR
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3027
Mailing Address - Country:US
Mailing Address - Phone:915-592-0012
Mailing Address - Fax:915-592-0201
Practice Address - Street 1:2267 TRAWOOD DR
Practice Address - Street 2:SUITE D-1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3027
Practice Address - Country:US
Practice Address - Phone:915-592-0012
Practice Address - Fax:915-592-0201
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT006308225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist