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Individual

MRS. ANGIE EVELYN OLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
462 COMMERCE DR STE A, MADISON, WI 53719-4987
(608) 833-0062
(608) 833-0431
Mailing address
1706 AUTUMN HILL DR, VERONA, WI 53593-7913
(608) 845-6225

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WI 2773
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38611800
WI
01
39176498400
UNITY
WI
Enumeration date
02/14/2006
Last updated
11/27/2007
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