Provider Demographics
NPI:1740653237
Name:UNWOD, LLC
Entity type:Organization
Organization Name:UNWOD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-791-9651
Mailing Address - Street 1:131 S WOODBURN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1195
Mailing Address - Country:US
Mailing Address - Phone:334-791-6920
Mailing Address - Fax:334-460-2300
Practice Address - Street 1:131 S WOODBURN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1195
Practice Address - Country:US
Practice Address - Phone:334-791-6920
Practice Address - Fax:334-460-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH30672251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty