Individual
WASIU A OMOTAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5414 W VILLARD AVE, MILWAUKEE, WI 53218-4224
(414) 241-2446
Mailing address
5414 W VILLARD AVE, MILWAUKEE, WI 53218-4224
(414) 241-2446
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
376G00000X
Nursing Home Administrator
Primary
—
WI
Other
Enumeration date
05/31/2025
Last updated
01/18/2026
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