Individual
MR. CHRISTIAN WILLIAM OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 PALM ST, CLEARWATER, FL 33755-1129
(727) 510-4584
(727) 442-2211
Mailing address
1250 PALM ST, CLEARWATER, FL 33755-1129
(727) 510-4584
(727) 442-2211
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002247100
—
FL
Enumeration date
12/06/2010
Last updated
12/06/2010
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