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Individual

CHARETTA SHAWNETTE OLIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
2121 FOUNTAIN DR, SUITE E, SNELLVILLE, GA 30078-7023
(770) 736-3330
Mailing address
3447 N DRUID HILLS RD, L, DECATUR, GA 30033-3764
(301) 520-6458

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
871175
DC
225100000X
Physical Therapist
Primary
PT012193
GA

Other

Enumeration date
05/12/2011
Last updated
05/10/2017
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