Organization
GENTLE FOOT CARE OF WESTERN OHIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SCOTT WILSON DPM (PODIATRIST/PRESIDENT)
(614) 239-0399
Entity
Organization
Contact information
Practice address
3800 WOODWARD AVE, STE 1102, DETROIT, MI 48201-2061
(313) 833-3090
(313) 833-7843
Mailing address
3255 E LIVINGSTON AVE, COLUMBUS, OH 43227-1923
(614) 239-0399
(614) 237-5220
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316191679
—
MI
01
—
6216330001
DMERCK
MI
Enumeration date
10/20/2009
Last updated
10/20/2009
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