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NPI Code Detail

MEDICARE: PAULETTE OLSON PT

MEDICARE: PAULETTE OLSON PT
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 Therapist7128AZ

General Provider Information

NPI Number : 1538376355
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULETTE OLSON PT
Provider Business Mailing Address
First Line : 38462 410TH ST
Second Line :
City : HERON LAKE
State : MN
Zip : 56137-2024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1617 S 67TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85043-7717
Country : US
Telephone Number : 623-707-2251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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Directions to “ PAULETTE OLSON PT” Practice Location

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