Organization
IVPS WOUND CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN W CHOLAK (PRACTICE ADMINISTRATOR)
(248) 497-8721
Entity
Organization
Contact information
Practice address
18000 W 9 MILE RD STE 525, SOUTHFIELD, MI 48075-4080
(248) 327-6196
Mailing address
18000 W 9 MILE RD STE 525, SOUTHFIELD, MI 48075-4080
(248) 327-6196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/20/2024
Last updated
05/20/2024
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