Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 808 | MA |
NPI | 1225170665 |
---|---|
Provider Name | Dr. George Albert Wood JR. |
First Address | Worcester, MA 01605-1916 |
Second Address | Worcester, MA 01605-1916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042894453 | COMMONWEALTH OF MA (01) | MA |
042894453 0003 | CIGNA INS (01) | MA |
1603400 | (05) | MA |
35213 | HARVARD PILGRIM INS (01) | MA |
715391 | TUFTS INSURANCE (01) | MA |
Y35555 | BLUE CROSS BLUE SHIELD MA (01) | MA |