MEDICARE: COMPREHENSIVE WOUND TREATMENT, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1730581190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE WOUND TREATMENT, PLLC

Provider Business Mailing Address
First Line	:	1501 TATE BLVD SE
Second Line	:	SUITE 105
City	:	HICKORY
State	:	NC
Zip	:	28602-1384
Country	:	US
Telephone Number	:	828-485-0324
Fax Number	:

Provider Business Practice Location Address
First Line	:	2872 S NC 127 HWY
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-9131
Country	:	US
Telephone Number	:	828-330-2103
Fax Number	:	828-294-0131

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN M BECHTOL
Credential	:	PA
Telephone Number	:	828-330-2103

Provider Enumeration Date	:	09/17/2014
Last Update Date	:	09/17/2014

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