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General NPI Number Information
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NPI Number | 1376745422
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Entity Type | Individual
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Provider Name | LOREN WOODS OTR
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2625 IOWA ST
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City | PERRY
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State | IA
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Zip | 50220-2413
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Country | US
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Telephone | 615-896-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 2215 NORTHWEST CAMEO LANE
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City | ANKENY
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State | IA
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Zip | 50023
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Country | US
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Telephone | 515-964-8765
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 00702
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License Number State | IA
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