Provider Demographics
NPI:1780022541
Name:OLSON, SAVANNAH MARIE (PT)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:MARIE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1040 CANADA AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1813
Mailing Address - Country:US
Mailing Address - Phone:701-751-3064
Mailing Address - Fax:
Practice Address - Street 1:1040 CANADA AVE STE 1
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1813
Practice Address - Country:US
Practice Address - Phone:701-751-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist