Individual
MR. GARY ALLEN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1992-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4940
DEAN HEALTH INUSRANCE
WI
Enumeration date
04/17/2008
Last updated
07/27/2012
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