MEDICARE: CARL OLSON D.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
1	225100000X	Physical Therapist	10329	SC
2	225100000X	Physical Therapist	032366	NY

General Provider Information

NPI Number	:	1861792509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL OLSON D.P.T.

Provider Business Mailing Address
First Line	:	2695 ELMS PLANTATION BLVD STE C
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-7132
Country	:	US
Telephone Number	:	843-974-8877
Fax Number	:	843-974-8878

Provider Business Practice Location Address
First Line	:	2695 ELMS PLANTATION BLVD STE C
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-7132
Country	:	US
Telephone Number	:	843-974-8877
Fax Number	:	843-974-8878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	01/27/2026

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