Individual
CHASSIE LE OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
903 MAIN AVE, CRIVITZ, WI 54114-1619
(715) 854-2717
Mailing address
W9319 COUNTY ROAD X, CRIVITZ, WI 54114-8546
(920) 606-5292
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
742-019
WI
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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