Healthcare Provider Details

I. General information

NPI: 1063234367
Provider Name (Legal Business Name): EXPERT WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

364 GREEN ST NE # 358
GAINESVILLE GA
30501-3310
US

IV. Provider business mailing address

364 GREEN ST NE # 358
GAINESVILLE GA
30501-3310
US

V. Phone/Fax

Practice location:
  • Phone: 404-315-8345
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY D GRIFFITH
Title or Position: OWNER
Credential:
Phone: 404-314-8345