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General NPI Number Information
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NPI Number | 1346563111
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Entity Type | Organization
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Legal Business Name | DAN WOOD PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 1828 TOWER DR
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City | MONROE
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State | LA
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Zip | 71201-4938
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Country | US
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Telephone | 318-338-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 3867 BAYOU ACRES DR
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City | BASTROP
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State | LA
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Zip | 71220-9232
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Country | US
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Telephone | 318-283-2080
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. DANIEL W. WOOD
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Credential | PHYSICAL THERAPY
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Telephone | 318-283-2080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | Z12328
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License Number State | LA
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