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Organization
OUTPATIENT WOUND SOLUTIONS, INC.
Active
Organization
OUTPATIENT WOUND SOLUTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN THOMAS MICHALUK DO (OWNER)
(707) 999-0242
Entity
Organization
Contact information
Practice address
607 ELMIRA RD, SUITE 165, VACAVILLE, CA 95687-4655
(707) 999-0242
Mailing address
607 ELMIRA RD, SUITE 165, VACAVILLE, CA 95687-4655
(707) 999-0242
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A10786
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7618939
—
CA
Enumeration date
05/04/2011
Last updated
04/05/2012
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