Provider Demographics
NPI:1548734569
Name:OM ALTERNATIVE HEALTH PARTNERS, INC
Entity Type:Organization
Organization Name:OM ALTERNATIVE HEALTH PARTNERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:262-475-3535
Mailing Address - Street 1:107 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-1157
Mailing Address - Country:US
Mailing Address - Phone:262-475-3535
Mailing Address - Fax:
Practice Address - Street 1:107 N 3RD ST
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:WI
Practice Address - Zip Code:53115-1157
Practice Address - Country:US
Practice Address - Phone:630-804-9537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-12
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty