Olson, Lance
Olson, Lance is an sole proprietor health care provider with primary practice located at 6097 Us Highway 6 , Portage IN 46368-5215. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Olson, Lance can be contacted via phone (219) 763-1538.Contact Information
Primary practice address
6097 Us Highway 6
Portage IN 46368-5215
Phone: (219) 763-1538
Fax: (219) 938-3385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18003103 | Indiana |
Profile Details
| NPI number | 1457444093 |
|---|---|
| LBN Legal business name | Olson, Lance |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Apr 6th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457444093 | NPPES |
| Indiana | MEDICAID | 200400920 |
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