BRIAN LANE OLSON

IDAHO FALLS, ID
NPI1013029792
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225XP0200X Occupational Therapist, Pediatrics
(Licence: ID  OT-513)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
-- BRIAN LANE OLSON
510 E 17TH ST # 400
IDAHO FALLS, ID 83404-6154
Phone number: 208-589-0807
Mailing Address
-- BRIAN LANE OLSON
510 E 17TH ST # 400
IDAHO FALLS, ID 83404-6154
Phone number:
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