Individual
BRIAN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1950 WASHINGTON ST, GRAFTON, WI 53024-2103
(414) 243-5853
Mailing address
217 S HIGHLAND AVE, THIENSVILLE, WI 53092-1805
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1331-39
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
AURORA HEALTH CARE
—
Enumeration date
05/06/2020
Last updated
05/06/2020
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