MEDICARE: LAURA WOOD LMT

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	225700000X	Massage Therapist	7501015651	MI

General Provider Information

NPI Number	:	1710750880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA WOOD LMT

Provider Business Mailing Address
First Line	:	828 CENTRE ST APT 7
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-3392
Country	:	US
Telephone Number	:	231-642-1192
Fax Number	:

Provider Business Practice Location Address
First Line	:	3337 S AIRPORT RD W STE 2
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7927
Country	:	US
Telephone Number	:	231-421-5213
Fax Number	:

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

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/01/2023

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Directions to “ LAURA WOOD LMT” Practice Location

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