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General NPI Number Information
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NPI Number | 1689862666
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Entity Type | Organization
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Legal Business Name | OMNI FOOTCARE ASSOCIATES, PC
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 13811 19 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-2705
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Country | US
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Telephone | 586-247-0840
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Fax | 586-247-7668
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Provider Business Mailing Address
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Address Line | 13811 19 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-2705
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Country | US
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Telephone | 586-247-0840
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Fax | 586-247-7668
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARNOLD BRYAN WOLF
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Credential | DPM
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Telephone | 586-247-0840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | AW001164
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License Number State | MI
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