Organization
GARY B. OLSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY B OLSON DDS (OWNER)
(715) 421-3366
Entity
Organization
Contact information
Practice address
3930 8TH ST S, SUITE 202, WISCONSIN RAPIDS, WI 54494-6511
(715) 421-3366
(715) 421-3353
Mailing address
3930 8TH ST S, SUITE 202, WISCONSIN RAPIDS, WI 54494-6511
(715) 421-3366
(715) 421-3353
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
5001723-005
WI
Other
Enumeration date
08/01/2011
Last updated
10/17/2011
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