Healthcare Provider Details

I. General information

NPI: 1992660567
Provider Name (Legal Business Name): EASTERN WOUND CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 MOORES LN
BRENTWOOD TN
37027-8021
US

IV. Provider business mailing address

2942 E CHAPMAN AVE STE 230
ORANGE CA
92869-3745
US

V. Phone/Fax

Practice location:
  • Phone: 615-656-0979
  • Fax:
Mailing address:
  • Phone: 615-656-0979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LIONEL HOLDEN LEE
Title or Position: OWNER
Credential:
Phone: 909-800-3958