Provider Demographics
NPI:1063767986
Name:WOOD, EMILY SUE (DPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SUE
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:954 RIDGEBROOK RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9440
Mailing Address - Country:US
Mailing Address - Phone:443-212-5745
Mailing Address - Fax:443-212-5749
Practice Address - Street 1:954 RIDGEBROOK RD STE 310
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9440
Practice Address - Country:US
Practice Address - Phone:443-212-5745
Practice Address - Fax:443-212-5749
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2024-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD24100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA244830ZAB2Medicare Oscar/Certification