Individual
MARI OLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E 1ST ST STE 203, DULUTH, MN 55805-2297
(218) 249-5555
Mailing address
1000 E 1ST ST STE 203, DULUTH, MN 55805-2297
(218) 249-5555
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MW4569490
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MW4569490
MEDICAL LICENSE
OR
Enumeration date
06/09/2016
Last updated
12/18/2020
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