Provider Demographics
NPI:1487780334
Name:HOOD, ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:HOOD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:BOLDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2645 N MAYFAIR RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1304
Mailing Address - Country:US
Mailing Address - Phone:414-476-2225
Mailing Address - Fax:414-476-2805
Practice Address - Street 1:2645 N MAYFAIR RD
Practice Address - Street 2:SUITE 140
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1304
Practice Address - Country:US
Practice Address - Phone:414-476-2225
Practice Address - Fax:414-476-2805
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4290111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38974600Medicaid
V11487Medicare UPIN
WI000335635Medicare PIN