Individual
MR. LARRY TODD OLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4132
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200035880A
—
OK
Enumeration date
11/07/2005
Last updated
02/11/2015
Update your record
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