Organization
ONLINE WOUND CARE GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY RAYBUCK (PRESIDENT)
(910) 310-4551
Entity
Organization
Contact information
Practice address
101 WESTPARK DR, BRENTWOOD, TN 37027-5031
(910) 310-4551
Mailing address
101 WESTPARK DR, BRENTWOOD, TN 37027-5031
(910) 310-4551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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