Basic Information
| Provider Information | |||||||||
| NPI: | 1396950424 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOUND CARE AND HYPERBARIC TREATMENT CENTER, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9875 S FRANKLIN DR | ||||||||
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| City: | FRANKLIN | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531328895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4148582206 | ||||||||
| FaxNumber: | 4148582236 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 ROBBINS RD | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 837024539 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084895809 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2007 | ||||||||
| LastUpdateDate: | 10/12/2007 | ||||||||
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| AuthorizedOfficialLastName: | CAROSELLI | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2084895809 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0011X | ID | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Undersea and Hyperbaric Medicine |
No ID Information.