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Individual

MR. PETER MICHAEL OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, ATC

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2795
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001665
TRICARE
NH
05
0715743
MA
01
08Y004081NH05
ANTHEM BC/BS
NH
01
1227022
AETNA
NH
05
30394917
NH
01
6400248
UNITED HEALTHCARE
NH
01
AA51374
HARVARD PILGRIM
NH
01
TAX-ID
CIGNA
NH
01
VX2303
MEDICARE
NH
Enumeration date
07/07/2005
Last updated
03/26/2008
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