Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Wound Care |
163WW0000X |
| NPI # | 1255142808 |
| LBN Legal business name | BIOMATRIX ADVANCED GRAFT SOLUTIONS LTD |
| Authorized official | BEVERLY THIELKE - (PROVIDER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 01/14/2025 |
| Last updated | 01/14/2025 - More than a year ago |
| Identifiers | n/a |
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