MEDICARE: WOODRUFF PHYSICAL THERAPY

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50Y544700NH01	OTHER	NH	ANTHEM

General Provider Information

NPI Number	:	1922193945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODRUFF PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	4 HAVERHILL RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4206
Country	:	US
Telephone Number	:	603-887-7800
Fax Number	:	603-887-7801

Provider Business Practice Location Address
First Line	:	4 HAVERHILL RD
Second Line	:
City	:	CHESTER
State	:	NH
Zip	:	03036-4206
Country	:	US
Telephone Number	:	603-887-7800
Fax Number	:	603-887-7801

Authorized Official
Title or Position	:	OWNER/PT
Name	:	JEFFREY L WOODRUFF
Credential	:	PT
Telephone Number	:	603-887-7800

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	08/22/2020

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