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General NPI Number Information
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NPI Number | 1598889651
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Entity Type | Organization
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Legal Business Name | RICHARD D WOLFF, DPM INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 1050 ISAAC STREETS DR SUITE 133
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City | OREGON
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State | OH
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Zip | 43616-3291
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Country | US
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Telephone | 419-693-0055
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Fax | 419-693-5025
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Provider Business Mailing Address
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Address Line | 1050 ISAAC STREETS DR SUITE 133
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City | OREGON
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State | OH
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Zip | 43616-3291
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Country | US
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Telephone | 419-693-0055
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Fax | 419-693-5025
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD DAVID WOLFF
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Credential | DPM
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Telephone | 419-693-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36.003380
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License Number State | OH
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