Provider Demographics
NPI:1427287747
Name:OLSON, LINDSAY MARIE (DPT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:OLSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:O'KEEFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:295 PHALEN BLVD
Mailing Address - Street 2:MAIL STOP 41201A
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-2400
Mailing Address - Country:US
Mailing Address - Phone:651-254-3200
Mailing Address - Fax:952-883-9637
Practice Address - Street 1:295 PHALEN BLVD
Practice Address - Street 2:MAIL STOP 41201A
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-2400
Practice Address - Country:US
Practice Address - Phone:651-254-3200
Practice Address - Fax:952-883-9637
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1427287747Medicaid