Healthcare Provider Details

I. General information

NPI: 1851027270
Provider Name (Legal Business Name): GARRETT OLSON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 7TH ST N
NORTHWOOD IA
50459-1053
US

IV. Provider business mailing address

605 BOYSON RD NE APT 119
CEDAR RAPIDS IA
52402-7390
US

V. Phone/Fax

Practice location:
  • Phone: 641-323-7334
  • Fax:
Mailing address:
  • Phone: 641-390-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number112261
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: