Provider Demographics
NPI:1730382961
Name:DANIEL WOOD PT INC
Entity type:Organization
Organization Name:DANIEL WOOD PT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EPPINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-283-2080
Mailing Address - Street 1:3867 BAYOU ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-9232
Mailing Address - Country:US
Mailing Address - Phone:318-283-2080
Mailing Address - Fax:318-283-0606
Practice Address - Street 1:105 DAVE L PEARCE
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:LA
Practice Address - Zip Code:71261
Practice Address - Country:US
Practice Address - Phone:318-428-2089
Practice Address - Fax:318-428-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5C737Medicare ID - Type Unspecified