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General NPI Number Information
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NPI Number | 1841814928
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Entity Type | Organization
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Legal Business Name | WOUNDS ON WHEELS LLC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 210 VALLEY VIEW TRL
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City | DALLAS
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State | GA
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Zip | 30132-5561
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Country | US
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Telephone | 678-463-3677
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Fax |
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Provider Business Mailing Address
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Address Line | 210 VALLEY VIEW TRL
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City | DALLAS
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State | GA
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Zip | 30132-5561
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Country | US
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Telephone | 678-463-3677
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MS. LORIA JEAN FLANAGAN
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Credential | CERTIFIED WOUND CARE
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Telephone | 678-463-3677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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