Provider Demographics
NPI:1831370949
Name:WOOD VISION CLINIC INC
Entity type:Organization
Organization Name:WOOD VISION CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-346-1688
Mailing Address - Street 1:203 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50665-7728
Mailing Address - Country:US
Mailing Address - Phone:319-346-1688
Mailing Address - Fax:319-346-1494
Practice Address - Street 1:203 3RD ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:IA
Practice Address - Zip Code:50665-7728
Practice Address - Country:US
Practice Address - Phone:319-346-1688
Practice Address - Fax:319-346-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5751220002Medicare NSC