Individual
GARRET WILLIAM WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5932 DAVID ST, CHUBBUCK, ID 83202-2057
(208) 850-6597
Mailing address
5932 DAVID ST, CHUBBUCK, ID 83202-2057
(208) 850-6597
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
AT-583
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
07/26/2019
Last updated
07/26/2019
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