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General NPI Number Information
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NPI Number | 1043701501
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Entity Type | Individual
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Provider Name | TAMARA WOOD LMT
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 45 WASHINGTON ST
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City | CONWAY
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State | NH
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Zip | 03818-6031
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Country | US
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Telephone | 603-447-1144
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 942
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City | GLEN
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State | NH
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Zip | 03838-0942
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Country | US
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Telephone | 603-986-0388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3219
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License Number State | NH
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