Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1679 | SD |
NPI | 1033556014 |
---|---|
Provider Name | Aaron Michael Olson |
First Address | Sioux Falls, SD 57117-5116 |
Second Address | Sioux Falls, SD 57105-2135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 24/06/2013 |