Individual
ALAN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3000
Mailing address
77 CHESTNUT DR, DERBY, CT 06418-2310
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
002643
CT
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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