Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT018604 | PA |
Y | 2251G0304X | Physical Therapist - Geriatrics | PT018604 | PA |
NPI | 1326552209 |
---|---|
Provider Name | Lynn Marie Olson |
First Address | Downingtown, PA 19335-4493 |
Second Address | West Chester, PA 19382-6453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 29/11/2017 |