Individual
MR. ERIC OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2450 E SHOW LOW LAKE RD STE 1, SHOW LOW, AZ 85901-7953
(928) 532-5577
Mailing address
2588 S FOREST MEADOW LN, PINETOP, AZ 85935-5016
(928) 528-7523
(928) 532-1969
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2263
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
578385
—
AZ
05
—
S6576
—
NM
Enumeration date
04/11/2006
Last updated
10/19/2018
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