Individual
KURT OLAVESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
975 CHAMBERS ST, SOUTH OGDEN, UT 84403-4591
(801) 387-6200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9495040-1205
UT
Other
Enumeration date
05/22/2014
Last updated
07/21/2022
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