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Individual

NICOLE OLSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1618 MILLENIUM WAY, STE 210, MERIDIAN, ID 83642-6439
(208) 884-4647
(208) 884-8984
Mailing address
1618 MILLENIUM WAY, STE 210, MERIDIAN, ID 83642-6439
(208) 884-4647
(208) 884-8984

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2771
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851457675
ID
Enumeration date
09/18/2008
Last updated
05/10/2022
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