Provider Demographics
NPI:1932961208
Name:WOOD, TODD KEVIN
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:KEVIN
Last Name:WOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 LAJOY DR
Mailing Address - Street 2:
Mailing Address - City:COVENTRY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1944
Mailing Address - Country:US
Mailing Address - Phone:330-344-0989
Mailing Address - Fax:
Practice Address - Street 1:552 LAJOY DR
Practice Address - Street 2:
Practice Address - City:COVENTRY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44319-1944
Practice Address - Country:US
Practice Address - Phone:330-344-0989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide