Organization
TEODOR 1 INCORPORATED DBA PERSONAL WOUND CARE SERVICES
Active
Other names
Personal Wound Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MICHELLE THEODORE REGISTERED NURSE (COO)
(267) 338-6382
Entity
Organization
Contact information
Practice address
8221 PROVIDENT STREET, PHILADELPHIA, PA 19150
(267) 338-6382
(888) 252-9279
Mailing address
8221 PROVIDENT STREET, PHILADELPHIA, PA 19150
(267) 338-6382
(888) 252-9279
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
—
—
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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