Provider Demographics
NPI:1942710587
Name:OLSON, ALEXANDER P
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:P
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 1:2052 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4746
Mailing Address - Country:US
Mailing Address - Phone:513-863-6383
Mailing Address - Fax:
Practice Address - Street 1:705 HANOVER ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3789
Practice Address - Country:US
Practice Address - Phone:513-785-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator