Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305212247 | VA |
NPI | 1053890236 |
---|---|
Provider Name | Joseph William Wood JR. |
First Address | Fishersville, VA 22939 |
Second Address | Waynesboro, VA 22980-7374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2018 |
Last Update Date | 09/08/2018 |