Individual
MR. CASEY OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, CSCS
Contact information
Practice address
1529 SEABRIGHT AVE, SANTA CRUZ, CA 95062-2528
(831) 458-6234
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
34299
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT342990
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
12/14/2007
Last updated
12/08/2021
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