Organization
OMNI FAMILY MEDICAL SC
Active
Organization
OMNI FAMILY MEDICAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWESI GRANT-ACQUAH (MD)
(414) 374-9575
Entity
Organization
Contact information
Practice address
1134 W NORTH AVE, MILWAUKEE, WI 53205-1333
(414) 374-9575
Mailing address
1134 W NORTH AVE, MILWAUKEE, WI 53205-1333
(414) 374-9575
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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