Provider Demographics
NPI:1033779277
Name:OLSEN-PETTY, MICHELLE (RN, MASTER IN ACUPUN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:OLSEN-PETTY
Suffix:
Gender:F
Credentials:RN, MASTER IN ACUPUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13-1 APPLE RDG
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-2709
Mailing Address - Country:US
Mailing Address - Phone:978-760-0342
Mailing Address - Fax:
Practice Address - Street 1:13-1 APPLE RDG
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2709
Practice Address - Country:US
Practice Address - Phone:978-760-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist