Organization
FOOTHEALS PODIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WACH D.P.M. (PRESIDENT)
(909) 623-4484
Entity
Organization
Contact information
Practice address
1520 N MOUNTAIN AVE STE 122, ONTARIO, CA 91762-1132
(909) 623-4484
(909) 623-4485
Mailing address
1520 N MOUNTAIN AVE STE 122, ONTARIO, CA 91762-1132
(909) 623-4484
(909) 623-4485
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E4125
CA
Other
Enumeration date
10/28/2013
Last updated
10/28/2013
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