Provider Demographics
NPI:1932775699
Name:WOOD, KELCIE DENYS (ATC)
Entity Type:Individual
Prefix:
First Name:KELCIE
Middle Name:DENYS
Last Name:WOOD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 ISBELL LN
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-6875
Mailing Address - Country:US
Mailing Address - Phone:409-926-1991
Mailing Address - Fax:
Practice Address - Street 1:1900 S SUNNYLANE RD
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3102
Practice Address - Country:US
Practice Address - Phone:409-926-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer