Organization Name: | WOUND CARE OF CAPE GIRARDEAU LLC |
NPI Number: | 1477818318 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER C JIANG (PRESIDENT) |
Mailing Address: | 211 Saint Francis Dr Cape Girardeau |
State: | MO US |
Postal Code: | 637035049 |
Phone Number: | 3148218055 |
Fax Number: | |
NPI Enumeration Date: | 07/06/2012 |
NPI Last Update Date: | 07/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD110547 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |