Individual
LEAH SUZANNE OLMSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 LAURENCE AVE STE E, JACKSON, MI 49202-2980
(517) 750-4777
Mailing address
3149 FAWN LN, JACKSON, MI 49201-9008
(517) 240-2431
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LEOL14
HIPPA
MI
Enumeration date
05/05/2019
Last updated
05/08/2019
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