Individual
SHANNON OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
800 40TH AVE E, WEST FARGO, ND 58078-7926
(701) 356-2160
Mailing address
3011 34TH ST S, MOORHEAD, MN 56560-6938
(701) 866-5298
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
251-02
ND
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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