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General NPI Number Information
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NPI Number | 1639823099
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Entity Type | Individual
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Provider Name | RACHEL ELIZABETH OLDS
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 1524 E BROADWAY ST
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City | MT PLEASANT
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State | MI
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Zip | 48858-2933
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Country | US
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Telephone | 989-854-8334
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Fax |
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Provider Business Mailing Address
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Address Line | 2824 STATEN AVE
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City | LANSING
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State | MI
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Zip | 48910-3752
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Country | US
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Telephone | 517-896-1190
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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