Basic Information
| Provider Information | |||||||||
| NPI: | 1609921154 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILO | ||||||||
| FirstName: | KATIE | ||||||||
| MiddleName: | OLSON | ||||||||
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| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OLSON | ||||||||
| OtherFirstName: | KATIE | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 797 WILSON ST | ||||||||
| Address2: | |||||||||
| City: | BREWER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044121000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079924042 | ||||||||
| FaxNumber: | 2079924043 | ||||||||
| Practice Location | |||||||||
| Address1: | 797 WILSON ST | ||||||||
| Address2: | |||||||||
| City: | BREWER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044121000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079924042 | ||||||||
| FaxNumber: | 2079924043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2007 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251P0200X | 17410 | MA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | 2251P0200X | 3000 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No ID Information.