Provider Demographics
NPI:1194009258
Name:OLSON, ALISON MARIE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48615 873RD RD
Mailing Address - Street 2:
Mailing Address - City:EMMET
Mailing Address - State:NE
Mailing Address - Zip Code:68734-3814
Mailing Address - Country:US
Mailing Address - Phone:402-340-4994
Mailing Address - Fax:
Practice Address - Street 1:300 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1514
Practice Address - Country:US
Practice Address - Phone:402-336-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE852225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant