MEDICARE: DR. PAUL SEVERIN WOOD DC

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	111N00000X	Chiropractor	7247	MN

General Provider Information

NPI Number	:	1700629680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SEVERIN WOOD DC

Provider Business Mailing Address
First Line	:	3640 TALMAGE CIR
Second Line	:
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110-4183
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:

Provider Business Practice Location Address
First Line	:	3640 TALMAGE CIR
Second Line	:
City	:	VADNAIS HEIGHTS
State	:	MN
Zip	:	55110-4183
Country	:	US
Telephone Number	:	651-429-2279
Fax Number	:

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

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/17/2024

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