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General NPI Number Information
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NPI Number | 1447324108
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Entity Type | Individual
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Provider Name | WALTER RHETT WOODY III MT
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 1428 WEATHERLY RD SE SUITE 109
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City | HUNTSVILLE
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State | AL
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Zip | 35803-1181
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Country | US
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Telephone | 256-882-7275
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Fax | 256-882-3853
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Provider Business Mailing Address
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Address Line | PO BOX 4112
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City | HUNTSVILLE
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State | AL
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Zip | 35815-4112
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Country | US
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Telephone | 256-882-7275
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Fax | 256-882-3853
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QM0706X
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Taxonomy Name | Medical Technologist
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License Number | 12353
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License Number State | AL
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