Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 15358 | MN |
NPI | 1366548406 |
---|---|
Provider Name | Dr. Barbara Ford Olson |
First Address | Golden Valley, MN 55427-0187 |
Second Address | Saint Cloud, MN 56303-2015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 08/07/2007 |