Healthcare Provider Details

I. General information

NPI: 1235208919
Provider Name (Legal Business Name): ANDREA WRAY WOOLRIDGE D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 86 AND TOPAWA RD
SELLS AZ
85634
US

IV. Provider business mailing address

7900 S J STOCK RD
TUCSON AZ
85746-7012
US

V. Phone/Fax

Practice location:
  • Phone: 520-295-2505
  • Fax: 520-295-2677
Mailing address:
  • Phone: 520-295-2503
  • Fax: 520-295-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3901
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: