| NPI | 1649469115 |
|---|---|
| Former Legal Business Name | THOMAS B WOOD OD, PLLC |
| Entity Type | Organization |
| Authorized Contact | MARY MANTINI Authorized Official 309-222-8275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000305) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2021-05-11 |