Provider Demographics
NPI:1821731282
Name:OLSON, DANIEL KLAYTON
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KLAYTON
Last Name:OLSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11976 84TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-3060
Mailing Address - Country:US
Mailing Address - Phone:612-644-0700
Mailing Address - Fax:
Practice Address - Street 1:490 HIGHWAY 96 W STE 300
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1961
Practice Address - Country:US
Practice Address - Phone:651-451-3016
Practice Address - Fax:651-481-7040
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics