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Individual

MR. LARRY TODD OLSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3400 S DOUGLAS BLVD, 302, OKLAHOMA CITY, OK 73150
(405) 733-8000
(405) 733-7820
Mailing address
3400 S DOUGLAS BLVD, 302, OKLAHOMA CITY, OK 73150
(405) 733-8000
(405) 733-7820

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
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