Individual
KIRK MYKEL OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
700 RAYOVAC DR., #103, MADISON, WI 53711-2479
(608) 238-5826
(608) 238-1221
Mailing address
700 RAYOVAC DR., #103, MADISON, WI 53711-2479
(608) 238-5826
(608) 238-1221
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1045705
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396753497
—
WI
Enumeration date
08/04/2006
Last updated
06/02/2021
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