Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 8681805-2401 | UT |
N | 2251N0400X | Physical Therapist - Neurology | 8681805-2401 | UT |
NPI | 1053820001 |
---|---|
Provider Name | Dr. Genevieve Noelle Olivier |
First Address | Salt Lake City, UT 84108 |
Second Address | Salt Lake City, UT 84108-1213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 01/12/2021 |