Provider Demographics
NPI:1548673601
Name:OLSEN, TASHA H (DPT)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:H
Last Name:OLSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2138
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-5416
Mailing Address - Country:US
Mailing Address - Phone:256-325-5400
Mailing Address - Fax:256-325-5469
Practice Address - Street 1:44 HUGHES RD
Practice Address - Street 2:SUITE 1050
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-3045
Practice Address - Country:US
Practice Address - Phone:256-325-5400
Practice Address - Fax:256-325-5469
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH71572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic