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General NPI Number Information
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NPI Number | 1144581828
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Entity Type | Individual
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Provider Name | TRACY L. OLSON DC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 18174 ADAMS CIR
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City | FORT MYERS
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State | FL
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Zip | 33967-3062
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Country | US
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Telephone | 678-836-5672
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Fax |
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Provider Business Mailing Address
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Address Line | 18174 ADAMS CIR
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City | FORT MYERS
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State | FL
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Zip | 33967-3062
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Country | US
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Telephone | 678-836-5672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CH13310
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License Number State | FL
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