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General NPI Number Information
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NPI Number | 1386916179
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Entity Type | Individual
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Provider Name | LESLIE OLSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-257-3070
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Fax |
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Provider Business Mailing Address
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Address Line | W170N5353 RIDGEWOOD DR
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-0676
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Country | US
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Telephone | 262-754-0647
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13237-40
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License Number State | WI
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