Provider Demographics
NPI:1518549955
Name:AMERICAN WOUND CARE CENTERS OF OHIO LLC
Entity Type:Organization
Organization Name:AMERICAN WOUND CARE CENTERS OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-389-6001
Mailing Address - Street 1:5050 BLAZER PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3361
Mailing Address - Country:US
Mailing Address - Phone:614-389-6001
Mailing Address - Fax:
Practice Address - Street 1:5050 BLAZER PKWY STE 102
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3361
Practice Address - Country:US
Practice Address - Phone:614-389-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty