Provider Demographics
NPI:1073358164
Name:OLSON, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8489 187TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273-9728
Mailing Address - Country:US
Mailing Address - Phone:320-979-5871
Mailing Address - Fax:
Practice Address - Street 1:103 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MN
Practice Address - Zip Code:56312-9176
Practice Address - Country:US
Practice Address - Phone:320-254-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist