Individual
MR. BRIAN KELLY WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Mailing address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1123933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1123933
STATE OF TX LICENSE
TX
Enumeration date
06/06/2006
Last updated
02/09/2012
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