Individual
LARA L WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3810 SPRINGHURST BLVD STE 200, LOUISVILLE, KY 40241-6162
(502) 583-1749
Mailing address
3810 SPRINGHURST BLVD STE 200, LOUISVILLE, KY 40241-6162
(502) 583-1749
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2196
KY
363AM0700X
Medical Physician Assistant
PA2196
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100447620
—
KY
Enumeration date
05/27/2014
Last updated
10/23/2024
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