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General NPI Number Information
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NPI Number | 1710707930
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Entity Type | Organization
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Legal Business Name | ENHANCED WOUND CARE LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1210 SPRING ST
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City | WESTON
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State | MO
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Zip | 64098-1154
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Country | US
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Telephone | 913-914-7296
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Fax | 800-856-8427
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Provider Business Mailing Address
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Address Line | 6440 AVONDALE DR STE 200-20
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City | NICHOLS HILLS
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State | OK
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Zip | 73116-6421
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Country | US
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Telephone | 913-424-3068
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREA HOLLEY
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Credential |
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Telephone | 913-914-7296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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