Organization
AMENIOHEAL WOUND CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER STOUT (MANAGER)
(337) 315-7927
Entity
Organization
Contact information
Practice address
1060 E FOOTHILL BLVD STE 201, UPLAND, CA 91786-4070
(909) 561-5577
Mailing address
1060 E FOOTHILL BLVD STE 201, UPLAND, CA 91786-4070
(909) 561-5577
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
174400000X
Specialist
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
05/15/2024
Last updated
05/24/2024
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