Provider Demographics
NPI:1285063412
Name:WOOD, JENNIFER (DPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 SW 24TH AVE
Mailing Address - Street 2:APT #1805
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-7817
Mailing Address - Country:US
Mailing Address - Phone:479-234-1448
Mailing Address - Fax:
Practice Address - Street 1:2025 SW 75TH ST
Practice Address - Street 2:SUITE NUMBER 30
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3453
Practice Address - Country:US
Practice Address - Phone:352-333-1900
Practice Address - Fax:352-333-1195
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 28614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist