Provider Demographics
NPI:1942304894
Name:OLSON, JOSEPH C (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:C
Last Name:OLSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 W MORRIS BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-3866
Mailing Address - Country:US
Mailing Address - Phone:423-317-7955
Mailing Address - Fax:423-317-7977
Practice Address - Street 1:1907 W MORRIS BLVD STE E
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-3866
Practice Address - Country:US
Practice Address - Phone:423-317-7955
Practice Address - Fax:423-317-7977
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1186225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist