Provider Demographics
NPI:1306562830
Name:ASCENT WOUND CARE LLC
Entity type:Organization
Organization Name:ASCENT WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-585-8677
Mailing Address - Street 1:2608 PEMBERLY AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-7568
Mailing Address - Country:US
Mailing Address - Phone:719-755-0446
Mailing Address - Fax:719-755-0508
Practice Address - Street 1:2608 PEMBERLY AVE
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7568
Practice Address - Country:US
Practice Address - Phone:719-755-0446
Practice Address - Fax:719-755-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty