Individual
MR. JESSE A WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, MSOM
Contact information
Practice address
107 N 3RD ST, DELAVAN, WI 53115-1157
(262) 475-3535
Mailing address
107 N 3RD ST, DELAVAN, WI 53115-1157
(262) 475-3535
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
198.001415
IL
171100000X
Acupuncturist
Primary
985-55
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198.001415
STATE
IL
01
—
985-55
STATE
WI
Enumeration date
02/14/2018
Last updated
11/08/2021
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