| Doctor Name: | KELLY LEE OLIVE |
| NPI Number: | 1326165176 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 1033801 |
| Business Practice Address: | 19965 Fm 3175 North Lytle, TX - 78052 |
| Business Phone Number: | 2103570369 |
| Business Fax Number: | 2103570458 |
| Mailing Address: | Po Box 725, LYTLE |
| State: | TX |
| Postal Code: | 780520725 |
| Phone Number: | 2103570369 |
| Fax Number: | 2103570369 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1033801 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |