Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 13354 | AZ |
NPI | 1013436310 |
---|---|
Provider Name | Nicholas Woods |
First Address | Flagstaff, AZ 86001-2000 |
Second Address | Flagstaff, AZ 86001-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2017 |
Last Update Date | 18/09/2017 |