MEDICARE: HOLLY MICHELLE WOODCOCK DPT

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	225100000X	Physical Therapist	PT024483	PA

General Provider Information

NPI Number	:	1528444767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY MICHELLE WOODCOCK DPT

Provider Business Mailing Address
First Line	:	113 VERNON CT
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-6813
Country	:	US
Telephone Number	:	484-941-3785
Fax Number	:

Provider Business Practice Location Address
First Line	:	785 STARR ST
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-3674
Country	:	US
Telephone Number	:	610-983-9300
Fax Number	:

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

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	08/10/2015

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