Provider Demographics
NPI:1841595071
Name:CLOUD WOUND CONSULTING LLC
Entity Type:Organization
Organization Name:CLOUD WOUND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CWS
Authorized Official - Phone:215-850-6323
Mailing Address - Street 1:747 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3504
Mailing Address - Country:US
Mailing Address - Phone:215-850-6323
Mailing Address - Fax:
Practice Address - Street 1:747 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3504
Practice Address - Country:US
Practice Address - Phone:215-850-6323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT015786225100000X, 225100000X
DEJ1-0003396225100000X
FLPT32897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty