Healthcare Provider Details

I. General information

NPI: 1932108602
Provider Name (Legal Business Name): MRS. FLORA J. WOOLFOLK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FLORA FRANCES JOHNSON

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17203 JAMES MADISON HWY
GORDONSVILLE VA
22942-8519
US

IV. Provider business mailing address

17203 JAMES MADISON HWY
GORDONSVILLE VA
22942-8519
US

V. Phone/Fax

Practice location:
  • Phone: 540-832-0303
  • Fax: 540-832-0303
Mailing address:
  • Phone: 540-832-0303
  • Fax: 540-832-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305001627
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: