Provider Demographics
NPI:1306693015
Name:WESTERN MA WOUND CARE INC.
Entity type:Organization
Organization Name:WESTERN MA WOUND CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-512-5111
Mailing Address - Street 1:63 FRENCH KING HWY
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1337
Mailing Address - Country:US
Mailing Address - Phone:413-512-5111
Mailing Address - Fax:413-512-5112
Practice Address - Street 1:63 FRENCH KING HWY
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1337
Practice Address - Country:US
Practice Address - Phone:413-512-5111
Practice Address - Fax:413-512-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty