Healthcare Provider Details

I. General information

NPI: 1689918575
Provider Name (Legal Business Name): WILLIAM J OLSZEWSKI OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COLBY CT
BEDFORD NH
03110-6426
US

IV. Provider business mailing address

30 COLBY CT
BEDFORD NH
03110-6426
US

V. Phone/Fax

Practice location:
  • Phone: 603-296-3712
  • Fax:
Mailing address:
  • Phone: 603-296-3712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number1434
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: