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General NPI Number Information
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NPI Number | 1023100682
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Entity Type | Individual
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Provider Name | JENNIFER OLSON RPT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1001 HIGHWAY 95 E STE 190
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City | CAMBRIDGE
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State | MN
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Zip | 55008-1769
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Country | US
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Telephone | 763-689-5385
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Fax |
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Provider Business Mailing Address
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Address Line | 1160 ANCHOR CT
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City | HARRIS
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State | MN
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Zip | 55032-2900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 6229
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License Number State | MN
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