Individual
DR. LANCE OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6097 US HIGHWAY 6, PORTAGE, IN 46368-5215
(219) 763-1538
(219) 938-3385
Mailing address
6801 MELTON RD STE C, GARY, IN 46403-3006
(219) 730-4559
(219) 938-3385
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003103
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200400920
—
IN
Enumeration date
10/02/2006
Last updated
04/06/2010
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