Provider Demographics
NPI:1295016921
Name:OLSON, HOLLY CHRISTINE (LMT, NCTM)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:CHRISTINE
Last Name:OLSON
Suffix:
Gender:F
Credentials:LMT, NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18335 SORREL SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-9697
Mailing Address - Country:US
Mailing Address - Phone:406-240-9266
Mailing Address - Fax:
Practice Address - Street 1:521 S 2ND ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-1832
Practice Address - Country:US
Practice Address - Phone:406-240-9266
Practice Address - Fax:406-543-1020
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1254225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist