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NPI 1649158676

NPI 1649158676 : EMMA LYNN WOODBURY : DEWITT, MI

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General NPI Number Information
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    NPI Number           |    1649158676
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    Entity Type          |    Individual 
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    Provider Name        |    EMMA LYNN WOODBURY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/26/2025
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    Last Update Date     |    08/26/2025
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Provider Practice Location Address
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    Address Line         |    13105 SCHAVEY RD STE 5 
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    City                 |    DEWITT
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    State                |    MI
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    Zip                  |    48820
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    Country              |    US
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    Telephone            |    517-853-6800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7748 W. HENDERSON ROAD 
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    City                 |    ELSIE
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    State                |    MI
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    Zip                  |    48831
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    Country              |    US
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    Telephone            |    989-640-4729
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    5502008748
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    License Number State |    MI
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