Organization

Midwest Wound & Wellness Llc

Clinic/Center in Farmington, MO(View on Map)

Legal Business Name

Midwest Wound & Wellness Llc

NPI Number

1215467733

NPI Type

Organization

Enumeration Date

06/18/2017

Specialties

(Taxonomies)

Code

261Q00000X
164W00000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

555 W PINE ST
555 W PINE ST

City

Farmington
Farmington

State

MO
MO

Postal Code

63640-1439
63640-1439

Country

US
US

Telephone Number

(573) 747-1510
(573) 747-1510

Authorized Official

Name

Kelly Roberts

Title or Position

OWNER

Telephone Number

(573) 747-1510

Identifiers

Identifier

1568912129

Identifier State

MO

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/21/2022

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