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Individual

HAILEY OLSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
500 W AQUA AVE, COEUR D ALENE, ID 83815-7764
(208) 762-1122
(208) 762-1680
Mailing address
500 W AQUA AVE, COEUR D ALENE, ID 83815-7764
(208) 762-1122
(208) 762-1680

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-408
ID

Other

Enumeration date
05/30/2008
Last updated
05/30/2008
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