Individual
ALYSSA OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 646-1222
Mailing address
71 HAYNES ST, MANCHESTER, CT 06040-4131
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
23.003596
CT
Other
Enumeration date
06/13/2016
Last updated
08/03/2016
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