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General NPI Number Information
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NPI Number | 1265577183
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Entity Type | Individual
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Provider Name | GREGORY ALLEN OLSON O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 N CENTER ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-5140
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Country | US
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Telephone | 410-857-4200
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Fax | 410-848-9295
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Provider Business Mailing Address
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Address Line | 13105 OLD HANOVER ROAD
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City | REISTERSTOWN
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State | MD
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Zip | 21136
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Country | US
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Telephone | 410-526-2724
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA0993
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License Number State | MD
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