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General NPI Number Information
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NPI Number | 1003349549
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Entity Type | Organization
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Legal Business Name | ON CALL WOUND CARE LLC
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 12798 FOREST HILL BLVD STE 205B
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City | WELLINGTON
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State | FL
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Zip | 33414-4768
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Country | US
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Telephone | 844-620-9701
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Fax | 561-877-5596
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Provider Business Mailing Address
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Address Line | 12798 FOREST HILL BLVD STE 205B
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City | WELLINGTON
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State | FL
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Zip | 33414-4768
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Country | US
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Telephone | 844-620-9701
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Fax | 561-877-5596
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DANA KENNETH THOMPSON
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Credential |
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Telephone | 844-620-9701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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