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General NPI Number Information
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NPI Number | 1962292409
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Entity Type | Organization
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Legal Business Name | MOBILE WOUND CARE SOLUTIONS INC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1616 WESTGATE CIR
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City | BRENTWOOD
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State | TN
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Zip | 37027-8019
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Country | US
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Telephone | 731-571-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 319 VANN DR STE E #60
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City | JACKSON
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State | TN
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Zip | 38305-6032
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Country | US
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Telephone | 731-571-0902
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN BALLINGER
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Credential |
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Telephone | 731-571-0902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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