Healthcare Provider Details

I. General information

NPI: 1225004567
Provider Name (Legal Business Name): ALLYSON COURTNEY WOOD M.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ALLYSON COURTNEY HOOD M.P.T.

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 HAMMOCK RD NW SUITE 106
MILLEDGEVILLE GA
31061-7184
US

IV. Provider business mailing address

220 GREYSTONE DRIVE
MILLEDGEVILLE GA
31061
US

V. Phone/Fax

Practice location:
  • Phone: 478-452-6252
  • Fax: 478-452-6255
Mailing address:
  • Phone: 478-452-6252
  • Fax: 478-452-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7191
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: