Provider Demographics
NPI:1851027270
Name:OLSON, GARRETT (DPT)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:OLSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 BOYSON RD NE APT 119
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7390
Mailing Address - Country:US
Mailing Address - Phone:641-390-0039
Mailing Address - Fax:
Practice Address - Street 1:704 7TH ST N
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:IA
Practice Address - Zip Code:50459-1053
Practice Address - Country:US
Practice Address - Phone:641-323-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1122612251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic