Provider Demographics
NPI:1902983604
Name:OLSON, CHRISTIAN K (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:K
Last Name:OLSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 DANCEGLEN DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-7688
Mailing Address - Country:US
Mailing Address - Phone:719-527-3976
Mailing Address - Fax:
Practice Address - Street 1:4220 DANCEGLEN DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-7688
Practice Address - Country:US
Practice Address - Phone:719-527-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5350509-9934152W00000X
COOPT-2705152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist