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Individual
MR. BAXTER OLIVER DEAL III
Active
Individual
MR. BAXTER OLIVER DEAL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, LOTR
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05284
LA
225X00000X
Occupational Therapist
Primary
OTT.Z12349
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1178543
—
LA
05
—
1467898
—
LA
Enumeration date
08/22/2006
Last updated
07/25/2016
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