MEDICARE: RYNE WOODARD DPT

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
1	225100000X	Physical Therapist	2305214326	VA

General Provider Information

NPI Number	:	1538732623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYNE WOODARD DPT

Provider Business Mailing Address
First Line	:	901 JEFFERSON ST APT 5C
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1653
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19733 MAIN ST FL 1
Second Line	:
City	:	BUCHANAN
State	:	VA
Zip	:	24066-5500
Country	:	US
Telephone Number	:	540-254-2126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	07/19/2021

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