MEDICARE: LEAH OLSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist	187615	IL

General Provider Information

NPI Number	:	1275912313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH OLSON

Provider Business Mailing Address
First Line	:	8000 RIVER POINTE DR
Second Line	:	APT 2B33
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113-8099
Country	:	US
Telephone Number	:	708-712-5746
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 RIVER POINTE DR
Second Line	:	APT 2B33
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72113-8099
Country	:	US
Telephone Number	:	708-712-5746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

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Directions to “ LEAH OLSON ” Practice Location

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