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Organization
MARK H OLSEN DPM PLLC
Active
Organization
MARK H OLSEN DPM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBIE J SOTA (OFFICE MANAGER)
(623) 234-8131
Entity
Organization
Contact information
Practice address
220 N STAPLEY DR, #1, MESA, AZ 85203-8057
(623) 234-8131
(623) 234-8147
Mailing address
220 N STAPLEY DR, #1, MESA, AZ 85203-8057
(623) 234-8131
(623) 234-8147
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0762
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
819643
—
AZ
Enumeration date
06/20/2014
Last updated
06/20/2014
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