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General NPI Number Information
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NPI Number | 1629625041
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Entity Type | Organization
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Legal Business Name | MARTIN WOUND CARE LLC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 11491 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0136
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Country | US
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Telephone | 256-505-6826
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Fax | 256-571-2862
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Provider Business Mailing Address
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Address Line | 5903 SPRING CIR
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City | GUNTERSVILLE
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State | AL
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Zip | 35976-2811
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Country | US
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Telephone | 256-505-6826
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Fax | 256-571-2862
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | SYDNEY JONES
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Credential | MACC
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Telephone | 256-505-6826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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