Provider Demographics
NPI:1972868248
Name:OLSEN, EMILE OTT (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILE
Middle Name:OTT
Last Name:OLSEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:EMILE
Other - Middle Name:ROSE
Other - Last Name:OTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:100 SPRUNT ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7811
Mailing Address - Country:US
Mailing Address - Phone:919-843-2164
Mailing Address - Fax:919-843-2195
Practice Address - Street 1:100 SPRUNT ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7811
Practice Address - Country:US
Practice Address - Phone:919-843-2164
Practice Address - Fax:919-843-2195
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13754225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist