Individual
COLLEEN M. OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
312 W 3RD ST, FAITH, SD 57626-6013
(605) 850-1532
(605) 374-5666
Mailing address
19415 US HIGHWAY 12, LEMMON, SD 57638-6303
(605) 850-1532
(605) 374-5666
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0468
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4999695
WELLMARK BCBS OF SD
SD
01
—
52628
ND MEDICAID
ND
05
—
5830960
—
SD
01
—
650023807
RAILROAD MEDICARE
SD
Enumeration date
02/09/2006
Last updated
11/06/2024
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