Individual
KENNETH R OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 E MAIN ST, WAUKON, IA 52172-1735
(563) 568-3449
(563) 568-4947
Mailing address
105 E MAIN ST, WAUKON, IA 52172-1735
(563) 568-3449
(563) 568-4947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19201
IA
207Q00000X
Family Medicine Physician
40911
WI
Other
Enumeration date
11/07/2005
Last updated
03/28/2012
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