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General NPI Number Information
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NPI Number | 1508629122
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Entity Type | Organization
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Legal Business Name | WELLSPRING WOUND CARE, LLC
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 4023 AMBASSADOR CAFFERY PKWY STE 520
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City | LAFAYETTE
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State | LA
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Zip | 70503-5268
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Country | US
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Telephone | 337-568-4325
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Fax | 337-446-8776
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Provider Business Mailing Address
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Address Line | 4023 AMBASSADOR CAFFERY PKWY STE 520
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City | LAFAYETTE
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State | LA
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Zip | 70503-5268
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Country | US
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Telephone | 337-568-4325
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Fax | 337-446-8776
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Authorized Official
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Title or Position | PRESIDENT/COO
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Name | MR. LEONARD CARL RAINEY
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Credential |
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Telephone | 337-278-5605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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