Individual
MR. LARRY JAMES OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.,CCC-A
Contact information
Practice address
13762 EMBER RD, RAPID CITY, SD 57702-7332
(605) 342-3207
Mailing address
13762 EMBER RD, RAPID CITY, SD 57702-7332
(605) 342-3207
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
018A
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5830480
—
SD
Enumeration date
08/19/2006
Last updated
07/08/2007
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