Individual
KEVIN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3882
Mailing address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-3882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
23.003118
CT
Other
Enumeration date
07/10/2014
Last updated
07/10/2014
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