Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TE1100X | Exercise & Sports Psychologist | ||
N | 225100000X | Physical Therapist | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1033568019 |
---|---|
Provider Name | Michael Wood |
First Address | Alhambra, CA 91801-2045 |
Second Address | Alhambra, CA 91801-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2016 |
Last Update Date | 09/06/2016 |