Provider Demographics
NPI:1750926903
Name:OLSEN, JOY E (MASSAGE THERAPIST L)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:E
Last Name:OLSEN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 E DAISY ST
Mailing Address - Street 2:
Mailing Address - City:WHITE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4413
Mailing Address - Country:US
Mailing Address - Phone:801-557-1384
Mailing Address - Fax:
Practice Address - Street 1:837 E DAISY ST
Practice Address - Street 2:
Practice Address - City:WHITE CITY
Practice Address - State:UT
Practice Address - Zip Code:84094-4413
Practice Address - Country:US
Practice Address - Phone:801-557-1384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4736280-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist