Provider Demographics
NPI:1942551650
Name:WOOD, SHAWN MICHAEL ARANA (DPT)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHAEL ARANA
Last Name:WOOD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 N ROBBINS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-4567
Mailing Address - Country:US
Mailing Address - Phone:208-489-4040
Mailing Address - Fax:208-489-4064
Practice Address - Street 1:600 N ROBBINS RD STE 101
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4567
Practice Address - Country:US
Practice Address - Phone:208-489-4040
Practice Address - Fax:208-489-4064
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist