Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 275196 | KY |
NPI | 1760143473 |
---|---|
Provider Name | Dr. Paige Rebecca Olsen |
First Address | Crestwood, KY 40014-7224 |
Second Address | Middletown, KY 40243-1541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2022 |
Last Update Date | 05/01/2022 |