Individual
GASTON ROBERT OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, LMT
Contact information
Practice address
32 UNION SQ E STE 612N, NEW YORK, NY 10003-3243
(917) 658-9097
Mailing address
32 UNION SQ E STE 612N, NEW YORK, NY 10003-3243
(917) 658-9097
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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