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Individual

RICHARD L OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
N3171 STARKEY LAKE RD., SHELL LAKE, WI 54871
(715) 468-2057
Mailing address
N3171 STARKEY LAKE RD., SHELL LAKE, WI 54871
(715) 468-2057

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
61226
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43394300
WI
Enumeration date
12/06/2006
Last updated
12/19/2007
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