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General NPI Number Information
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NPI Number | 1225253412
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Entity Type | Organization
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Legal Business Name | WOODNEV
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Dates
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Enumeration Date | 04/15/2007
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Last Update Date | 06/15/2008
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Provider Practice Location Address
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Address Line | 990 8TH ST S UNIT 1B
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City | NAPLES
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State | FL
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Zip | 34102-8215
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Country | US
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Telephone | 239-435-1497
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Fax |
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Provider Business Mailing Address
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Address Line | 990 8TH ST S UNIT 1B
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City | NAPLES
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State | FL
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Zip | 34102-8215
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Country | US
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Telephone | 239-435-1497
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Fax |
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Authorized Official
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Title or Position | WONER
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Name | JEAN ANN WOODILLA
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Credential | LYMPHEDEMA THERAPIST
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Telephone | 239-435-1497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MM14949
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License Number State | FL
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