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NPI Code Detail

MEDICARE: LAQUATA LYNN WOOD

MEDICARE:   LAQUATA LYNN WOOD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH0200XHome Health Registered Nurse3651840OH

General Provider Information

NPI Number : 1508122045
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAQUATA LYNN WOOD
Provider Business Mailing Address
First Line : 2908 LOFFER CT
Second Line :
City : DAYTON
State : OH
Zip : 45449-3621
Country : US
Telephone Number : 937-251-2058
Fax Number :
Provider Business Practice Location Address
First Line : 2908 LOFFER CT
Second Line :
City : DAYTON
State : OH
Zip : 45449-3621
Country : US
Telephone Number : 937-251-2058
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2012
Last Update Date : 04/10/2012

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Directions to “ LAQUATA LYNN WOOD ” Practice Location

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