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General NPI Number Information
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NPI Number | 1477948743
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Entity Type | Individual
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Provider Name | GLENN CHRISTOPHER WOODLEY D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 06/26/2021
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Provider Practice Location Address
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Address Line | 3355 LAKE ARIEL HWY
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City | HONESDALE
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State | PA
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Zip | 18431-1156
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Country | US
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Telephone | 570-228-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 3355 LAKE ARIEL HWY
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City | HONESDALE
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State | PA
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Zip | 18431-1156
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Country | US
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Telephone | 570-228-2990
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO4009
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006677
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License Number State | PA
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