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Individual

KYLIE MAE WOODARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
136 W BELMONT DR, SUITE 12, CALHOUN, GA 30701-3064
(706) 625-0662
(706) 625-0582
Mailing address
136 W BELMONT DR, SUITE 12, CALHOUN, GA 30701-3064
(706) 625-0662
(706) 625-0582

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTO12523
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTO12523
PT LICENSE
GA
Enumeration date
08/11/2016
Last updated
03/19/2018
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