Provider Demographics
NPI:1386784411
Name:OLZENAK, DANA LEE (PT, DPT, MBA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LEE
Last Name:OLZENAK
Suffix:
Gender:F
Credentials:PT, DPT, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 COUNTY ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-3119
Mailing Address - Country:US
Mailing Address - Phone:315-268-3787
Mailing Address - Fax:315-268-1539
Practice Address - Street 1:10 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WADDINGTON
Practice Address - State:NY
Practice Address - Zip Code:13694
Practice Address - Country:US
Practice Address - Phone:315-388-7703
Practice Address - Fax:315-388-4707
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0186672251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics