Provider Demographics
NPI:1053923003
Name:RHODES, OLIVIA HUDSON (PT, DPT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:HUDSON
Last Name:RHODES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:EVELYN
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13937 S SPRAGUE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7864
Mailing Address - Country:US
Mailing Address - Phone:334-391-3926
Mailing Address - Fax:
Practice Address - Street 1:13937 S SPRAGUE LN STE 100
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7864
Practice Address - Country:US
Practice Address - Phone:334-391-3926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031693225100000X
ALPTH10356225100000X
GAPT014778225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist