Provider Demographics
NPI:1386877009
Name:WOOD'S AND WOOD'S SPA WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:WOOD'S AND WOOD'S SPA WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH CARE PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD; MTD
Authorized Official - Phone:919-794-8157
Mailing Address - Street 1:4823 MEADOW DR STE 103
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9208
Mailing Address - Country:US
Mailing Address - Phone:919-597-1944
Mailing Address - Fax:
Practice Address - Street 1:4823 MEADOW DR STE 103
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9208
Practice Address - Country:US
Practice Address - Phone:919-597-1944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29976261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty