Individual
RANDY RAY OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
505 5TH AVE NW, ROSEAU, MN 56751-1718
(218) 463-1999
(218) 463-1909
Mailing address
505 5TH AVE NW, ROSEAU, MN 56751-1718
(218) 463-1999
(218) 463-1909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4761
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64 04526
MEDICA
MN
01
—
8B771OL
BCBSM
MN
Enumeration date
10/10/2006
Last updated
07/08/2007
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