Provider Demographics
NPI:1437411964
Name:OLSON, SARA LYNN (MPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:OLSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:GLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:600 PLEASANT AVENUE
Mailing Address - Street 2:ST. JOSEPH'S AREA HEALTH SERVICES
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470
Mailing Address - Country:US
Mailing Address - Phone:218-237-5496
Mailing Address - Fax:218-237-5702
Practice Address - Street 1:600 PLEASANT AVENUE
Practice Address - Street 2:ST. JOSEPH'S AREA HEALTH SERVICES
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470
Practice Address - Country:US
Practice Address - Phone:218-237-5496
Practice Address - Fax:218-237-5702
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist