Organization
WOUND CARE INTERVENTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI PIERSANTI (MANAGING DIRECTOR)
(877) 969-6863
Entity
Organization
Contact information
Practice address
777 MAIN ST STE 600, FORT WORTH, TX 76102-5368
(877) 969-6493
Mailing address
3617 N BAY BREEZE LN, FORT WORTH, TX 76179-3824
(877) 969-6863
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/09/2023
Last updated
05/21/2024
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