Individual
DR. BRADLEY RICHARD OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
70
ND
213ES0103X
Foot & Ankle Surgery Podiatrist
797
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18500
—
ND
05
—
1871762997
—
MN
Enumeration date
02/22/2008
Last updated
04/14/2014
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