Provider Demographics
NPI:1184747404
Name:NWAOBI, OLUNWA M (BSC, MSC, PHD)
Entity type:Individual
Prefix:DR
First Name:OLUNWA
Middle Name:M
Last Name:NWAOBI
Suffix:
Gender:M
Credentials:BSC, MSC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280132
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38168-0132
Mailing Address - Country:US
Mailing Address - Phone:901-870-3508
Mailing Address - Fax:
Practice Address - Street 1:305 VALLEY DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-1505
Practice Address - Country:US
Practice Address - Phone:901-870-3508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist