Individual
MISS DETTLEFF ELMER OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(765) 973-6915
Mailing address
405 VALLEYVIEW DR, ENGLEWOOD, OH 45322-1313
(937) 836-5597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-005936
OH
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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