Healthcare Provider Details

I. General information

NPI: 1255120929
Provider Name (Legal Business Name): ALL HEALTH WOUND CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 N VENEER RD UNIT 208
COEUR D ALENE ID
83814-7987
US

IV. Provider business mailing address

3208 N VENEER RD UNIT 208
COEUR D ALENE ID
83814-7987
US

V. Phone/Fax

Practice location:
  • Phone: 405-626-2282
  • Fax:
Mailing address:
  • Phone: 405-626-2282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN C KELM
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 405-626-2282