Individual
ANNE COURTNEY OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 TUCSON DR, AMARILLO, TX 79109-5530
(806) 356-0747
Mailing address
4105 TUCSON DR, AMARILLO, TX 79109-5530
(806) 356-0747
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
FKP 5750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08020736
DRIVER'S LICENSE
TX
Enumeration date
06/25/2015
Last updated
06/25/2015
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