Individual
KELLEEN WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1600 E SUMMIT ST, RED OAK, IA 51566-1709
(712) 623-5156
Mailing address
26 BONNER LN, OFFUTT A F B, NE 68113-1055
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
004842
IA
225200000X
Physical Therapy Assistant
1057
NE
Other
Enumeration date
05/27/2012
Last updated
05/27/2012
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