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MR. STEPHEN PRESTON OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTRL

Contact information

Practice address
3060 FRONTIER WAY S, FARGO, ND 58104-8909
(701) 232-2340
Mailing address
3060 FRONTIER WAY S, FARGO, ND 58104-8909
(701) 232-2340
(701) 232-2330

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
102480
MN
225XP0200X
Pediatric Occupational Therapist
Primary
662
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24652
BCBS ND PROVIDER NUM.
ND
01
371G3OL
BCBS MN PROVIDER NUM.
MN
01
371GOL
EPNI POV. NUM.
ND
01
54885
NDMA PROVIDER NUMBER
ND
01
HP50728
HEALTH PARTNERS PROV NUM
ND
Enumeration date
01/08/2007
Last updated
01/17/2019
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