Provider Demographics
NPI:1871489419
Name:WOUNDOLOGY CORP
Entity type:Organization
Organization Name:WOUNDOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIGRID
Authorized Official - Middle Name:CHANTELLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-333-1863
Mailing Address - Street 1:2909 LANCER AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-2516
Mailing Address - Country:US
Mailing Address - Phone:714-582-9072
Mailing Address - Fax:
Practice Address - Street 1:2909 LANCER AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-2516
Practice Address - Country:US
Practice Address - Phone:714-582-9072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty