# MR. BAXTER OLIVER DEAL III

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1679689566
- **Gender:** Man
- **Credential:** MPT, LOTR

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 05284 | LA | — |
| 225X00000X | Occupational Therapist | OTT.Z12349 | LA | Yes |

## Other

- **Enumeration date:** 08/22/2006
- **Last updated:** 07/25/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1178543 | — | LA |
| 05 | — | 1467898 | — | LA |