Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46433 | CO |
Y | 2080P0205X | Pediatric Endocrinologist | MED-PHYS-LIC-11422 | MT |
NPI | 1528114139 |
---|---|
Provider Name | Colleen Wood |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 17/04/2019 |