Provider Demographics
NPI:1689750176
Name:WOOD, LOUISE J (DPT)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:J
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:J
Other - Last Name:POIRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1045 E KLATT RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3541
Mailing Address - Country:US
Mailing Address - Phone:907-245-1245
Mailing Address - Fax:907-245-1244
Practice Address - Street 1:1045 E KLATT RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3541
Practice Address - Country:US
Practice Address - Phone:907-245-1245
Practice Address - Fax:907-245-1244
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK298174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK92-0135259OtherTAX ID#