Provider Demographics
NPI:1275590820
Name:OLSON, DONNA ELTER (ATC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:ELTER
Last Name:OLSON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 COUNTY ROAD 2041
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-0470
Mailing Address - Country:US
Mailing Address - Phone:936-715-0676
Mailing Address - Fax:
Practice Address - Street 1:211 S TIMBERLAND DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-4065
Practice Address - Country:US
Practice Address - Phone:936-632-5511
Practice Address - Fax:936-632-5633
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT25882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer