Provider Demographics
NPI:1316689326
Name:WOUND LOGIX INC
Entity type:Organization
Organization Name:WOUND LOGIX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMRSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-742-8988
Mailing Address - Street 1:708 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2429
Mailing Address - Country:US
Mailing Address - Phone:609-742-8988
Mailing Address - Fax:609-939-0539
Practice Address - Street 1:708 KINGSTON CT
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2429
Practice Address - Country:US
Practice Address - Phone:609-742-8988
Practice Address - Fax:609-939-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty