Individual
LISA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
9573 W SILVERSPRING ST, BOISE, ID 83709-5762
(208) 585-7456
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
LRT-1234
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LRT-1234
RESPIRATORY THERAPIST
ID
Enumeration date
07/28/2021
Last updated
07/28/2021
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