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General NPI Number Information
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NPI Number | 1750556122
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Entity Type | Organization
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Legal Business Name | OMNI THERAPIES, INC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 2616 210TH ST
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City | WASHINGTON
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State | IA
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Zip | 52353-9226
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Country | US
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Telephone | 319-653-7200
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Fax | 319-653-7200
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Provider Business Mailing Address
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Address Line | 2616 210TH ST
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City | WASHINGTON
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State | IA
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Zip | 52353-9226
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Country | US
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Telephone | 319-653-7200
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Fax | 319-653-7200
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRADLEY ANDREW ALDERTON
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Credential | DC
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Telephone | 319-653-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 06635
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License Number State | IA
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