Individual
MR. TERRY WAYNE OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
530 ELM AVE, BROOKINGS, SD 57006-3427
(605) 696-4198
Mailing address
917 12TH ST S, BROOKINGS, SD 57006-3876
(605) 697-5051
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0036
SD
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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