Provider Demographics
NPI:1861587594
Name:WOODARD, AMY E (MSPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:WOODARD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 POST RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3265
Mailing Address - Country:US
Mailing Address - Phone:401-781-4441
Mailing Address - Fax:401-781-4446
Practice Address - Street 1:1160 POST RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-3265
Practice Address - Country:US
Practice Address - Phone:401-781-4441
Practice Address - Fax:401-781-4446
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist