Healthcare Provider Details

I. General information

NPI: 1033737366
Provider Name (Legal Business Name): WOUND SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 OLD LARAMIE TRL STE 100
LAFAYETTE CO
80026-7014
US

IV. Provider business mailing address

130 OLD LARAMIE TRL STE 100
LAFAYETTE CO
80026-7014
US

V. Phone/Fax

Practice location:
  • Phone: 866-649-6863
  • Fax:
Mailing address:
  • Phone: 866-649-6863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JACKSON CRAIG BAILEY
Title or Position: CEO
Credential: MBA
Phone: 866-649-6863