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Organization
PRO-ACTIVE WOUND CARE CLINICS LLC
Active
Organization
PRO-ACTIVE WOUND CARE CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE E HOOGENDOORN DPM (OWNER)
(614) 366-3838
Entity
Organization
Contact information
Practice address
5920 WILCOX PL, SUITE E, DUBLIN, OH 43016-6802
(614) 336-3838
(614) 336-3933
Mailing address
5920 WILCOX PL, SUITE E, DUBLIN, OH 43016-6802
(614) 336-3838
(614) 336-3933
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2468986
—
OH
Enumeration date
07/09/2006
Last updated
11/29/2007
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