Individual
TRAVIS LEE OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
414 E CLARK ST, DAKOTA DOME #112, VERMILLION, SD 57069-2307
(605) 677-5960
Mailing address
1308 S ROWLEY ST, MITCHELL, SD 57301-4713
(605) 933-1436
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
390200000
SD
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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