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Organization
LAFAYETTE'S WOUND CENTER, LLC
Active
Organization
LAFAYETTE'S WOUND CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY HUIZAR DPT (CEO)
(765) 838-1660
Entity
Organization
Contact information
Practice address
635 S EARL AVE, SUITE B, LAFAYETTE, IN 47904-3603
(765) 838-8208
(765) 838-8207
Mailing address
635 S EARL AVE, SUITE B, LAFAYETTE, IN 47904-3603
(765) 838-8208
(765) 838-8207
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
213E00000X
Podiatrist
—
NULL
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
NULL
364S00000X
Clinical Nurse Specialist
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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