Provider Demographics
NPI:1457722027
Name:URLING, OLIVIA V
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:V
Last Name:URLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2276 NORTHBROOK RDG NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7310
Mailing Address - Country:US
Mailing Address - Phone:678-938-5292
Mailing Address - Fax:770-693-0018
Practice Address - Street 1:2276 NORTHBROOK RDG NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7310
Practice Address - Country:US
Practice Address - Phone:678-938-5292
Practice Address - Fax:770-693-0018
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA900938137171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor