Individual
TONJA OLIPHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
240 BRANCHVIEW DR NE, CONCORD, NC 28025-3498
(704) 723-4705
Mailing address
802 LINWOOD RD, MOORESVILLE, NC 28115-8236
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4999
NC
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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