Provider Demographics
NPI:1740021203
Name:PARKER, OLIVIA (DPT)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 ZEPHYR RD UNIT 214
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-1733
Mailing Address - Country:US
Mailing Address - Phone:860-204-2008
Mailing Address - Fax:
Practice Address - Street 1:10 FARRELL ST STE 7
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6371
Practice Address - Country:US
Practice Address - Phone:802-864-6262
Practice Address - Fax:802-864-6252
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist