Provider Demographics
NPI:1043696099
Name:WOOD, ALLISON (MBA, ATC, LAT)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:MBA, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S CLEARVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:LA
Mailing Address - Zip Code:70121-1015
Mailing Address - Country:US
Mailing Address - Phone:504-520-6702
Mailing Address - Fax:504-520-7934
Practice Address - Street 1:1201 S CLEARVIEW PKWY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-1015
Practice Address - Country:US
Practice Address - Phone:504-520-6702
Practice Address - Fax:504-520-7934
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2003572255A2300X
COAT.00011802255A2300X
FLAL26972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer