| Organization Name: | THE WOUND PRACTITIONER, LLC |
| NPI Number: | 1295751626 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROSELLA SMALLEY (SOLE PROPRIETER) |
| Mailing Address: | 2415 N Gateway Ave Harriman |
| State: | TN US |
| Postal Code: | 377488609 |
| Phone Number: | 8658822442 |
| Fax Number: | |
| NPI Enumeration Date: | 07/15/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | APN0000010924 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |