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NPI Code Detail

MEDICARE: MARISSA A WOODEN PT

MEDICARE:   MARISSA A WOODEN  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 TherapistPT-1726WY

General Provider Information

NPI Number : 1871013482
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA A WOODEN PT
Provider Business Mailing Address
First Line : 1541 CENTENNIAL CT
Second Line :
City : CASPER
State : WY
Zip : 82609-7304
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 234 E 1ST ST STE 10
Second Line :
City : CASPER
State : WY
Zip : 82601-2516
Country : US
Telephone Number : 307-235-3910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2017
Last Update Date : 04/27/2021

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Directions to “ MARISSA A WOODEN PT” Practice Location

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