Healthcare Provider Details

I. General information

NPI: 1538043112
Provider Name (Legal Business Name): ALISON JEAN OLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 LUELLA ST
WATKINS MN
55389-1012
US

IV. Provider business mailing address

410 LUELLA ST
WATKINS MN
55389-1012
US

V. Phone/Fax

Practice location:
  • Phone: 320-764-2300
  • Fax:
Mailing address:
  • Phone: 320-764-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: