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General NPI Number Information
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NPI Number | 1700181682
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Entity Type | Organization
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Legal Business Name | MOBILE WOUND SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 1916 NW COPPER OAKS CIR
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-8300
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Country | US
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Telephone | 913-708-8258
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Fax | 913-708-8289
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Provider Business Mailing Address
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Address Line | 1916 NW COPPER OAKS CIR
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-8300
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Country | US
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Telephone | 913-708-8258
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Fax | 913-708-8289
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS W BLOCK
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Credential | DO
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Telephone | 913-708-8258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R6P79
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License Number State | MO
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