Individual
GINNIE M OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOMT, PT
Contact information
Practice address
4141 PENNOCK ST, HOMER, AK 99603-7223
(907) 235-3410
Mailing address
40589 MORNING STAR RD, HOMER, AK 99603-9470
(907) 223-1181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
AA765
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PT0710
—
AK
Enumeration date
08/24/2006
Last updated
05/24/2018
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