Healthcare Provider Details

I. General information

NPI: 1992206189
Provider Name (Legal Business Name): JOSEPH CASEY OLOFSSON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 04/03/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 STATE CIR
ANN ARBOR MI
48108-1646
US

IV. Provider business mailing address

680 STATE CIR
ANN ARBOR MI
48108-1646
US

V. Phone/Fax

Practice location:
  • Phone: 734-707-7285
  • Fax:
Mailing address:
  • Phone: 734-707-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501017290
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: