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General NPI Number Information
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NPI Number | 1962677526
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Entity Type | Organization
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Legal Business Name | FOOT WELLNESS CENTER
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 10/13/2008
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Provider Practice Location Address
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Address Line | 1442 N FARWELL AVE SUITE 605
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City | MILWAUKEE
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State | WI
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Zip | 53202-2996
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Country | US
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Telephone | 414-271-0670
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Fax | 414-271-2396
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Provider Business Mailing Address
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Address Line | 1839A E EUCLID AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-2943
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Country | US
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Telephone | 414-271-0670
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Fax | 414-271-2396
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL M. ZEROVEC
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Credential | DPM
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Telephone | 414-271-0670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 802025
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License Number State | WI
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