Provider Demographics
NPI:1134322506
Name:WOOD, DONALD EVERETT II (MSPT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:EVERETT
Last Name:WOOD
Suffix:II
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 FLAX HILL RD APT D4
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2852
Mailing Address - Country:US
Mailing Address - Phone:607-435-1549
Mailing Address - Fax:
Practice Address - Street 1:1250 SUMMER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5358
Practice Address - Country:US
Practice Address - Phone:203-975-1545
Practice Address - Fax:203-975-1544
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT008049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist