Provider Demographics
NPI:1275742215
Name:WOOD, JOHN DAVID
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DAVID
Last Name:WOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:DAVID
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4801 DRESSLER RD NW
Mailing Address - Street 2:SUITE184B
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3667
Mailing Address - Country:US
Mailing Address - Phone:330-491-0228
Mailing Address - Fax:
Practice Address - Street 1:4801 DRESSLER RD NW
Practice Address - Street 2:SUITE184B
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3667
Practice Address - Country:US
Practice Address - Phone:330-491-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1524237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist