Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 07680 | |
N | 175L00000X | Homeopath | 07860 |
NPI | 1336425008 |
---|---|
Provider Name | Jane Oelke |
First Address | Saint Joseph, MI 49085-3338 |
Second Address | Saint Joseph, MI 49085-3338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2011 |
Last Update Date | 26/10/2011 |