Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 1264347 | TX |
NPI | 1447627690 |
---|---|
Provider Name | Erin Wood |
First Address | San Antonio, TX 78258 |
Second Address | San Antonio, TX 78258 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 24/08/2015 |