MEDICARE: MR. TAYLOR RYAN WOODS ATC, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1518289818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAYLOR RYAN WOODS ATC, CSCS

Provider Business Mailing Address
First Line	:	1001 3RD ST SW
Second Line	:	APT 607
City	:	WASHINGTON
State	:	DC
Zip	:	20024-4417
Country	:	US
Telephone Number	:	202-713-5775
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 EYE ST NW
Second Line	:	ATHLETICS
City	:	WASHINGTON
State	:	DC
Zip	:	20001-1425
Country	:	US
Telephone Number	:	202-336-7104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2010
Last Update Date	:	02/27/2010

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