Organization
PROACTIVE WOUND CARE ID INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAYLEY WILLIAMS (OFFICE MANAGER)
(801) 815-6862
Entity
Organization
Contact information
Practice address
2270 HIGHWAY 89, FISH HAVEN, ID 83287-5139
(801) 815-6862
Mailing address
PO BOX 607, CENTERVILLE, UT 84014-0607
(801) 815-6862
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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