MEDICARE: WOUND CARE SOLUTIONS OF MISSOURI INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1730923111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND CARE SOLUTIONS OF MISSOURI INC

Provider Business Mailing Address
First Line	:	15325 OLD TOWN DR STE 113
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15325 OLD TOWN DR STE 113
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2523
Country	:	US
Telephone Number	:	901-428-2778
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DANIEL JAMES
Credential	:
Telephone Number	:	770-714-9292

Provider Enumeration Date	:	06/21/2024
Last Update Date	:	06/21/2024

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