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Individual

WILLIAM CARL JOHAN OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 529-6111
Mailing address
4448 ARSENAL RD, AMMON, ID 83406-8045
(630) 780-8019

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
74273
ID

Other

Enumeration date
02/26/2025
Last updated
03/03/2025
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Product
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