Organization
SOUTHSIDE WOUND CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL F HAZELWOOD (OPERATIONS MANAGER)
(434) 517-3515
Entity
Organization
Contact information
Practice address
2232 WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 517-3914
(434) 517-3912
Mailing address
P O BOX 1115, SOUTH BOSTON, VA 24592-1115
(434) 517-3515
(434) 572-4952
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
VA
Other
Enumeration date
09/15/2006
Last updated
08/22/2020
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