Doctor Name: | DR. LARRY L. OLSEN |
NPI Number: | 1740240852 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 881 |
Business Practice Address: | 501 E 15th St Suite 101 Edmond, OK - 730135043 |
Business Phone Number: | 4053412062 |
Business Fax Number: | 4053416553 |
Mailing Address: | 501 E 15th St, Suite 101 EDMOND |
State: | OK |
Postal Code: | 730135043 |
Phone Number: | 4053412062 |
Fax Number: | 4053416553 |
NPI Enumeration Date: | 03/23/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 881 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |