Organization
C. MICHAEL WOOD OPTOMETRIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES MICHAEL WOOD OD (OWNER)
(812) 649-4266
Entity
Organization
Contact information
Practice address
102 N 6TH ST, ROCKPORT, IN 47635-1460
(812) 649-4266
(812) 649-4279
Mailing address
102 N 6TH ST, ROCKPORT, IN 47635-1460
(812) 649-4266
(812) 649-4279
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001549A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224880A
—
IN
Enumeration date
02/25/2008
Last updated
06/26/2008
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