Organization
TLC HEALTHCARE WOUND SPECIALISTS INC
Active
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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