Healthcare Provider Details
I. General information
NPI: 1174932792
Provider Name (Legal Business Name): WOUND CARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/07/2014
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2727 S PENNSYLVANIA AVE
LANSING MI
48910-3488
US
IV. Provider business mailing address
1031 E SAGINAW ST
LANSING MI
48906-5519
US
V. Phone/Fax
- Phone: 517-975-1500
- Fax: 517-975-1514
- Phone: 517-487-1288
- Fax: 517-487-1129
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LESLIE
R
SEARLS
Title or Position: PRESIDENT
Credential: DO
Phone: 517-487-1288