Healthcare Provider Details

I. General information

NPI: 1538462056
Provider Name (Legal Business Name): WOUND CARE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 10/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 LOGAN CT
LOVELAND CO
80538-3100
US

IV. Provider business mailing address

945 LOGAN CT
LOVELAND CO
80538-3100
US

V. Phone/Fax

Practice location:
  • Phone: 970-290-2072
  • Fax: 970-669-2260
Mailing address:
  • Phone: 970-290-2072
  • Fax: 970-669-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number58113
License Number StateCO

VIII. Authorized Official

Name: JOYCE C HONEA
Title or Position: OWNER/PROVIDER
Credential: NP
Phone: 970-290-2072