Individual
ERIN RAE OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109
(817) 731-9331
(817) 731-9882
Mailing address
6080 SOUTHWEST BLVD, BENBROOK, TX 76109-3912
(817) 731-9331
(817) 731-9882
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2072156
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2072156
TX PTA LICENSE
TX
Enumeration date
07/24/2009
Last updated
07/24/2009
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