Provider Demographics
NPI:1780293985
Name:OLIVER, ANDREW WILLIE (DPT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:WILLIE
Last Name:OLIVER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 PRITCHARD TER
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-6295
Mailing Address - Country:US
Mailing Address - Phone:804-314-1856
Mailing Address - Fax:
Practice Address - Street 1:1506 PRITCHARD TER
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6295
Practice Address - Country:US
Practice Address - Phone:804-314-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214429225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist