Individual
LISA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 WOODS WALK, VILLA RICA, GA 30180
(812) 431-1098
Mailing address
1207 WOODS WALK, VILLA RICA, GA 30180-6912
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
32001740A
IN
224Z00000X
Occupational Therapy Assistant
A4278
KY
224Z00000X
Occupational Therapy Assistant
Primary
OTA001291
GA
Other
Enumeration date
01/04/2010
Last updated
10/11/2011
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