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NPI Code Detail

MEDICARE: MR. PAUL BRIAN WOODWARD PT

MEDICARE: MR. PAUL BRIAN WOODWARD PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist3005MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104925049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL BRIAN WOODWARD PT
Provider Business Mailing Address
First Line : 31 W GROVE ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-1859
Country : US
Telephone Number : 508-947-5195
Fax Number : 508-947-3447
Provider Business Practice Location Address
First Line : 31 W GROVE ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-1859
Country : US
Telephone Number : 508-947-5195
Fax Number : 508-947-3447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 10/04/2011

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