Provider Demographics
NPI:1083313662
Name:LEHIGH VALLEY WOUND SPECIALISTS
Entity Type:Organization
Organization Name:LEHIGH VALLEY WOUND SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED WOUND CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SHAUGHNESSY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CWS
Authorized Official - Phone:610-349-2381
Mailing Address - Street 1:1930 MARK TWAIN CIR
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-1540
Mailing Address - Country:US
Mailing Address - Phone:610-349-2381
Mailing Address - Fax:
Practice Address - Street 1:1930 MARK TWAIN CIR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-1540
Practice Address - Country:US
Practice Address - Phone:610-349-2381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty