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General NPI Number Information
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NPI Number | 1598171431
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE HEALTH INITIATIVE LLC
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 307 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-5700
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Country | US
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Telephone | 920-486-1439
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Fax |
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Provider Business Mailing Address
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Address Line | 307 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-5700
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Country | US
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Telephone | 920-486-1439
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MS. LEOLA JACOBI
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Credential | LAC
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Telephone | 262-483-3926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 539-55
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License Number State | WI
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