Organization
INTEGRATED WOUND HEALING,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GOODENOUGH (EXECUTIVE DIRECTOR)
(607) 725-0980
Entity
Organization
Contact information
Practice address
384 S PANTOPS DR, CHARLOTTESVILLE, VA 22911-8678
(607) 725-0980
Mailing address
384 S. PANTOPS DRIVE, CHARLOTTESVILLE, VA 22911
(607) 725-0980
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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