Provider Demographics
NPI:1053790584
Name:OLSON, BROOKE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:OLSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 W. 94TH TERRACE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207
Mailing Address - Country:US
Mailing Address - Phone:913-345-1997
Mailing Address - Fax:913-345-1990
Practice Address - Street 1:5250 W. 94TH TERRACE STE. 200
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207
Practice Address - Country:US
Practice Address - Phone:913-345-1997
Practice Address - Fax:913-345-1990
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1105041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist