Individual
CONNOR GUSTAV OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, LAT, ATC
Contact information
Practice address
1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2217
(715) 832-1400
(715) 832-4187
Mailing address
1200 OAKLEAF WAY STE A, ALTOONA, WI 54720-2217
(715) 832-1400
(715) 832-4187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
5937-23
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228838
—
WI
Enumeration date
12/06/2017
Last updated
06/05/2026
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