Individual
MR. EVAN ROBERT OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 439-1234
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11064
MN
225100000X
Physical Therapist
4589
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8895729
MEDICARE
WA
Enumeration date
10/22/2010
Last updated
05/14/2018
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