Individual
OLIVIA SANDERSON GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
391 SOUTHCREST CIR, SOUTHAVEN, MS 38671-6730
(091) 522-7700
Mailing address
6325 HUMPHREYS BLVD, MEMPHIS, TN 38120-2300
(901) 522-7700
(901) 522-2600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15300
TN
225100000X
Physical Therapist
Primary
PT7612
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200006016
—
MS
05
—
Q088576
—
TN
Enumeration date
08/08/2023
Last updated
12/12/2023
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