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General NPI Number Information
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NPI Number | 1659965457
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Entity Type | Organization
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Legal Business Name | OHIO WOUND CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 12301 RIDGE RD
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-3744
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Country | US
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Telephone | 440-652-8748
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Fax | 440-582-3171
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Provider Business Mailing Address
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Address Line | 5741 SHIELDS RD STE B
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City | CANFIELD
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State | OH
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Zip | 44406-9814
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Country | US
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Telephone | 440-652-8748
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Fax | 440-582-3171
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | TRACY WIMBERG JR.
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Credential |
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Telephone | 609-517-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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