Individual
THOMAS ANTHONY OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
2115 SUMMIT AVE, SAINT PAUL, MN 55105-1096
(612) 968-5133
Mailing address
1591 106TH AVE NW, COON RAPIDS, MN 55433-6308
(612) 968-5133
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000028350
NATA BOARD OF CERTIFICATION
—
01
—
3105
MINNESOTA STATE LICENSURE
MN
Enumeration date
11/22/2016
Last updated
01/31/2022
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