Gorham, Olivia Claire

Gorham, Olivia Claire is an individual health care provider with primary practice located at 4402 Williams Dr Ste 115 , Georgetown TX 78628-1388. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Gorham, Olivia Claire can be contacted via phone (512) 256-7627.

Contact Information

Primary practice address
4402 Williams Dr Ste 115 Georgetown TX 78628-1388
Phone: (512) 256-7627
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 2251P0200X 1335632 Texas

Profile Details

NPI number 1497369466
LBN Legal business name Gorham, Olivia Claire
Credentials PT, DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2020
Last updated Sep 7th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497369466 NPPES
Texas Other 1335632 PHYSICAL THERAPY LICENSE NUMBER

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