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Organization
QUALITY WOUND CARE LLC
Active
Organization
QUALITY WOUND CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIYAMIKE EZALA (PRESIDENT)
(913) 405-4416
Entity
Organization
Contact information
Practice address
12022 BLUE VALLEY PKWY, OVERLAND PARK, KS 66213-2647
(913) 405-4416
Mailing address
26061 W 150TH ST, OLATHE, KS 66061-8511
(913) 405-4416
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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