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NPI Code Detail

MEDICARE: MRS. JAMIE RENEE WOODRUFF P.T.

MEDICARE: MRS. JAMIE RENEE WOODRUFF P.T.
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 TherapistPT006831LPA
2225100000XPhysical Therapist2305003183VA

General Provider Information

NPI Number : 1558486753
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE RENEE WOODRUFF P.T.
Provider Business Mailing Address
First Line : 1125 SKYVIEW DR
Second Line :
City : MILTON
State : PA
Zip : 17847-7607
Country : US
Telephone Number : 570-742-7099
Fax Number : 570-742-6015
Provider Business Practice Location Address
First Line : 1901 N 5TH ST
Second Line :
City : HARRISBURG
State : PA
Zip : 17102-1510
Country : US
Telephone Number : 717-221-7900
Fax Number : 717-221-7908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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