Provider Demographics
NPI:1992018592
Name:OLSON, KAREN DENISE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DENISE
Last Name:OLSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 W WINDMILLS BLVD
Mailing Address - Street 2:#1051
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1354
Mailing Address - Country:US
Mailing Address - Phone:806-676-3369
Mailing Address - Fax:
Practice Address - Street 1:1475 N GRANITE REEF RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3919
Practice Address - Country:US
Practice Address - Phone:480-990-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8808APTA225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant