MEDICARE: DR. LORI OLSON D.C.

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	111NR0400X	Rehabilitation Chiropractor	4083	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	111T5PO	OTHER	MN	BCBS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457485575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI OLSON D.C.

Provider Business Mailing Address
First Line	:	1121 JACKSON ST NE STE 130
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55413-1637
Country	:	US
Telephone Number	:	612-741-2736
Fax Number	:	612-252-0379

Provider Business Practice Location Address
First Line	:	1121 JACKSON ST NE STE 130
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55413-1637
Country	:	US
Telephone Number	:	612-741-2736
Fax Number	:	612-252-0379

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	10/14/2025

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