MEDICARE: DR. LISA WOOD D,C,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	1823	MA

General Provider Information

NPI Number	:	1699894147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA WOOD D,C,

Provider Business Mailing Address
First Line	:	118 WASHINGTON ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1373
Country	:	US
Telephone Number	:	508-429-8003
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 WASHINGTON ST
Second Line	:
City	:	HOLLISTON
State	:	MA
Zip	:	01746-1373
Country	:	US
Telephone Number	:	508-429-8003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	10/24/2014

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