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General NPI Number Information
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NPI Number | 1700208436
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Entity Type | Individual
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Provider Name | ANDREW WOOD MS, ATC, LAT, CES
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Gender | Male
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 02/27/2015
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Provider Practice Location Address
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Address Line | 4600 TRINITY RD
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City | RALEIGH
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State | NC
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Zip | 27607-3924
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Country | US
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Telephone | 919-513-7140
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Fax | 919-515-8932
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Provider Business Mailing Address
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Address Line | 5451 MARKRIDGE RD 8223
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City | RALEIGH
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State | NC
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Zip | 27607-4096
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Country | US
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Telephone | 919-519-7140
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Fax | 919-515-8932
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1895
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License Number State | NC
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