| NPI | 1083227797 |
|---|---|
| Doing Business As | WOUND-1 |
| Entity Type | Organization |
| Authorized Contact | BEVERLY HODGES Provider 209-800-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2025-06-17 |