Organization
TLC HEALTHCARE WOUND SPECIALISTS INC
Active
Other names
Northwest Wound Care Specialists, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT M BOLHACK MD (OWNER/AUTHORIZED OFFICIAL)
(520) 670-0745
Entity
Organization
Contact information
Practice address
5130 N CIRCULO SOBRIO, TUCSON, AZ 85718-6036
(520) 670-0745
(520) 509-4496
Mailing address
2850 NORTH COUNTY CLUB ROAD, TUCSON, AZ 85716-1910
(520) 322-6274
(520) 509-4496
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422390
—
AZ
Enumeration date
04/13/2009
Last updated
04/10/2019
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