MEDICARE: DR. RONALD CLARK WOOD III P.T.

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
1	225100000X	Physical Therapist	021702	NY

General Provider Information

NPI Number	:	1518966464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD CLARK WOOD III P.T.

Provider Business Mailing Address
First Line	:	140 OFFICE PARK WAY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1758
Country	:	US
Telephone Number	:	585-271-1670
Fax Number	:	585-271-1675

Provider Business Practice Location Address
First Line	:	140 OFFICE PARK WAY
Second Line	:
City	:	PITTSFORD
State	:	NY
Zip	:	14534-1758
Country	:	US
Telephone Number	:	585-271-1670
Fax Number	:	585-271-1675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/27/2021

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