Provider Demographics
NPI:1942831607
Name:KURT R. OLSON, OD LLC
Entity Type:Organization
Organization Name:KURT R. OLSON, OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-341-6163
Mailing Address - Street 1:715 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66508-1841
Mailing Address - Country:US
Mailing Address - Phone:785-562-2631
Mailing Address - Fax:785-562-4006
Practice Address - Street 1:715 BROADWAY
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:66508-1841
Practice Address - Country:US
Practice Address - Phone:785-562-2631
Practice Address - Fax:785-562-4006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty