Provider Demographics
NPI:1841742574
Name:THERESA A OSMER PC
Entity Type:Organization
Organization Name:THERESA A OSMER PC
Other - Org Name:FLOW CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:OSMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-200-8606
Mailing Address - Street 1:4945 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-200-8606
Mailing Address - Fax:
Practice Address - Street 1:4945 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3722
Practice Address - Country:US
Practice Address - Phone:616-200-8606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230100997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty