Provider Demographics
NPI:1124726591
Name:POLINSKI, OLIVIA KATHLEEN ALTHEA (LMT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:KATHLEEN ALTHEA
Last Name:POLINSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8682 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:HOWARD CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49329-9274
Mailing Address - Country:US
Mailing Address - Phone:231-519-4136
Mailing Address - Fax:
Practice Address - Street 1:5856 FEDERAL RD
Practice Address - Street 2:
Practice Address - City:HOWARD CITY
Practice Address - State:MI
Practice Address - Zip Code:49329-8635
Practice Address - Country:US
Practice Address - Phone:616-430-8641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist