| Doctor Name: | MR. ERIC OLSON |
| NPI Number: | 1083677876 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 2263 |
| Business Practice Address: | 5171 Cub Lake Rd Suite 350-c Show Low, AZ - 859017888 |
| Business Phone Number: | 9285321970 |
| Business Fax Number: | 9285321969 |
| Mailing Address: | 2588 S Forest Meadow Ln, PINETOP |
| State: | AZ |
| Postal Code: | 859355016 |
| Phone Number: | 9285287523 |
| Fax Number: | 9285321969 |
| NPI Enumeration Date: | 04/11/2006 |
| NPI Last Update Date: | 12/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2263 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |