Healthcare Provider Details

I. General information

NPI: 1740103191
Provider Name (Legal Business Name): REMY OLSON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 ARROWHEAD WAY 865
CRESTONE CO
81131
US

IV. Provider business mailing address

PO BOX 865
CRESTONE CO
81131-0865
US

V. Phone/Fax

Practice location:
  • Phone: 719-401-3212
  • Fax:
Mailing address:
  • Phone: 323-541-3214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0024326
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: