Provider Demographics
NPI:1518966464
Name:WOOD, RONALD CLARK III (PT)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:CLARK
Last Name:WOOD
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:140 OFFICE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1758
Mailing Address - Country:US
Mailing Address - Phone:585-271-1670
Mailing Address - Fax:585-271-1675
Practice Address - Street 1:140 OFFICE PARK WAY
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1758
Practice Address - Country:US
Practice Address - Phone:585-271-1670
Practice Address - Fax:585-271-1675
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA0404Medicare ID - Type Unspecified