Organization
PRAIRIE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW OLSON MD (SOLE OWNER)
(608) 306-1804
Entity
Organization
Contact information
Practice address
37868 US HIGHWAY 18, PRAIRIE DU CHIEN, WI 53821-8416
(702) 453-3799
(702) 453-5741
Mailing address
PO BOX 195, PRAIRIE DU CHIEN, WI 53821-0195
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55436-20
WI
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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