Individual
JOHN M EVELSIZER OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Mailing address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
082179
IA
363AS0400X
Surgical Physician Assistant
Primary
082179
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639483001
—
IA
Enumeration date
07/28/2010
Last updated
01/13/2025
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