Healthcare Provider Details

I. General information

NPI: 1366079998
Provider Name (Legal Business Name): CLINIC ON WHEELS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 03/07/2023
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PEACHTREE ST STE B
MURPHY NC
28906-2940
US

IV. Provider business mailing address

30 PEACHTREE ST STE B
MURPHY NC
28906-2940
US

V. Phone/Fax

Practice location:
  • Phone: 828-321-8035
  • Fax: 515-478-7299
Mailing address:
  • Phone: 828-321-8035
  • Fax: 515-478-7299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER DEEMS WOODS
Title or Position: FNP
Credential: FNP
Phone: 404-518-9760