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Organization
DIANE J. WOOLDRIDGE, PHYSICAL THERAPY, PLLC
Active
Organization
DIANE J. WOOLDRIDGE, PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE J WOOLDRIDGE PT (PT/SOLE PROPRIETOR)
(315) 853-1401
Entity
Organization
Contact information
Practice address
3507 POST ST, CLINTON, NY 13323-4716
(315) 853-1401
(315) 853-7629
Mailing address
3507 POST ST, CLINTON, NY 13323-4716
(315) 853-1401
(315) 853-7629
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
009744-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02302078
—
NY
01
—
435741
MVP
NY
01
—
650024491
RAILROAD MEDICARE
NY
01
—
P010009744
BC/BS
NY
Enumeration date
08/31/2006
Last updated
01/05/2011
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