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General NPI Number Information
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NPI Number | 1710949151
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Entity Type | Individual
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Provider Name | CHRISTY KING WOODRUFF OTRL
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Gender | Female
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 2880 W 5TH ST
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City | GREENVILLE
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State | NC
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Zip | 27834-6166
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Country | US
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Telephone | 252-717-9668
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Fax | 252-321-0484
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Provider Business Mailing Address
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Address Line | 2880 W 5TH ST
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City | GREENVILLE
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State | NC
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Zip | 27834-6166
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Country | US
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Telephone | 252-717-9668
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Fax | 252-321-0484
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 2627
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2627
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License Number State | NC
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