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General NPI Number Information
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NPI Number | 1891456984
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Entity Type | Individual
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Provider Name | ANNA M WOODS ATC
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Gender | Female
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Dates
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Enumeration Date | 01/01/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 615 N WORDSWORTH LN
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5127
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Country | US
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Telephone | 901-828-1106
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Fax |
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Provider Business Mailing Address
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Address Line | 6235 CHOCTAW TRAILS
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City | OLIVE BRANCH
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State | MS
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Zip | 38654
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2702
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License Number State | AL
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