Individual
BLAKE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
453 W 10TH AVE, COLUMBUS, OH 43210-2205
(614) 292-1706
Mailing address
610 MORRIS LANE BLUE RUN RD, LUCASVILLE, OH 45648-8376
(740) 464-9632
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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