Individual
GRANT SYLVESTER OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-5398
Mailing address
2829 UNIVERSITY AVE SE STE 730, MINNEAPOLIS, MN 55414-3279
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
14009
MN
363A00000X
Physician Assistant
Primary
14009
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/07/2020
Last updated
09/30/2022
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