Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DN25524 | FL |
NPI | 1063008308 |
---|---|
Provider Name | Julie Ann Barrons Olsen |
First Address | Gainesville, FL 32608-4996 |
Second Address | Gainesville, FL 32605-5818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2020 |
Last Update Date | 20/12/2020 |