Organization
SUSAN J OLSON MD - PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS J LICARY MBA (AGENT FOR CORPORATION)
(843) 712-1854
Entity
Organization
Contact information
Practice address
333 WELCOME DR, MYRTLE BEACH, SC 29579-5374
(843) 712-1854
Mailing address
333 WELCOME DR, MYRTLE BEACH, SC 29579-5374
(843) 712-1854
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/17/2009
Last updated
11/20/2014
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