Provider Demographics
NPI:1750671681
Name:THOMAS OLSON
Entity Type:Organization
Organization Name:THOMAS OLSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:803-366-9440
Mailing Address - Street 1:724 ARDEN LN STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3257
Mailing Address - Country:US
Mailing Address - Phone:803-366-9440
Mailing Address - Fax:803-366-7704
Practice Address - Street 1:724 ARDEN LN STE 200
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3257
Practice Address - Country:US
Practice Address - Phone:803-366-9440
Practice Address - Fax:803-366-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC604332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies