Individual
CASSANDRA WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.003061
IL
363A00000X
Physician Assistant
1080
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0379PA
—
SC
Enumeration date
04/28/2006
Last updated
04/01/2022
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