Provider Demographics
NPI:1033801568
Name:COMPLETE WOUND CARE LLC
Entity Type:Organization
Organization Name:COMPLETE WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WYLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-408-2462
Mailing Address - Street 1:20 AUTUMN CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3316
Mailing Address - Country:US
Mailing Address - Phone:203-408-2462
Mailing Address - Fax:
Practice Address - Street 1:67 MASONIC AVE STE 2400
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3099
Practice Address - Country:US
Practice Address - Phone:203-408-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty