Individual
DR. GARY OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
285 COMMACK RD, SUITE 10, COMMACK, NY 11725-3403
(631) 462-0917
(631) 462-1038
Mailing address
285 COMMACK RD, SUITE 10, COMMACK, NY 11725-3403
(631) 462-0917
(631) 462-1038
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
XO9393-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5897489
GHI
NY
01
—
X7S551
EMPIRE BLUE CROSS BLUE SH
NY
Enumeration date
10/23/2006
Last updated
07/09/2007
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