Individual
TY CONRAD OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MSC10 5610, ALBUQUERQUE, NM 81731
(505) 272-4161
(505) 272-2776
Mailing address
1701 W CHARLESTON BLVD STE 400, LAS VEGAS, NV 89102-2320
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2024-0401
NM
Other
Enumeration date
05/07/2018
Last updated
11/10/2025
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