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General NPI Number Information
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NPI Number | 1467038794
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Entity Type | Individual
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Provider Name | NADINE OMARI
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Gender | Female
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Dates
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Enumeration Date | 03/18/2021
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 200 SAND CREEK HWY
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City | ADRIAN
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State | MI
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Zip | 49221-1255
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Country | US
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Telephone | 734-495-0059
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Fax |
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Provider Business Mailing Address
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Address Line | 4345 LUANN AVE
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City | TOLEDO
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State | OH
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Zip | 43623-4112
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Country | US
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Telephone | 419-490-5218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA012427
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License Number State | MI
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