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NPI Code Detail

MEDICARE: BARBARA ANN OLSON P.T.

MEDICARE: BARBARA ANN OLSON P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist7091AZ

General Provider Information

NPI Number : 1053516948
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA ANN OLSON P.T.
Provider Business Mailing Address
First Line : 5052 S OPAL RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-6807
Country : US
Telephone Number : 928-774-0674
Fax Number :
Provider Business Practice Location Address
First Line : 3150 N WINDING BROOK RD
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-0972
Country : US
Telephone Number : 928-774-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2007
Last Update Date : 07/08/2007

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