1154279917 NPI number — IRON MOUNTAIN ACUPUNCTURE AND WELLNESS

Table of content: MISS ALEXYS KATHRINE OLSON MSN, RN (NPI 1043168800)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154279917 NPI number — IRON MOUNTAIN ACUPUNCTURE AND WELLNESS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IRON MOUNTAIN ACUPUNCTURE AND WELLNESS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154279917
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
608 E D ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRON MOUNTAIN
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49801-3528
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-721-7182
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 CARPENTER AVE STE 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRON MOUNTAIN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49801-4768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
906-282-4450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2026

Additional Information

Authorized Official

Authorized Official Last Name:
TRELOAR
Authorized Official First Name:
KIRA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER AND ACUPUNCTURIST
Authorized Official Telephone Number:
262-721-7182

Provider Taxonomy Codes

  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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