Individual
GASTON ROBERT OLSEN
Active
Individual
GASTON ROBERT OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, LMT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006770-01
NY
225700000X
Massage Therapist
018439
NY
225700000X
Massage Therapist
018439-01
NY
Other
Enumeration date
06/05/2019
Last updated
09/13/2021
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