Organization
OMNI WELLNESS GROUP LLC
Active
Other names
Omni Wellness Group
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA PETREQUIN (BILLING MANAGER)
(937) 438-9500
Entity
Organization
Contact information
Practice address
1149 EXPERIMENT FARM ROAD, TROY, OH 45373
(937) 540-9920
(937) 202-0213
Mailing address
1149 EXPERIMENT FARM RD, TROY, OH 45373-1071
(937) 438-9500
(937) 886-5694
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/18/2018
Last updated
10/30/2023
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