| Organization Name: | BOTHWELL WOUND SERVICES |
| NPI Number: | 1528300126 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES A ROBERTSON (CFO) |
| Mailing Address: | 667 E 15th St Sedalia |
| State: | MO US |
| Postal Code: | 653017656 |
| Phone Number: | 6608272525 |
| Fax Number: | 6608272204 |
| NPI Enumeration Date: | 03/21/2013 |
| NPI Last Update Date: | 03/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
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Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |