Individual
TYLER WOODCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1739 ELM CT, SUITE 205, JEFFERSON CITY, MO 65101-4303
(573) 681-0447
Mailing address
9 CLINKSCALES RD # A, COLUMBIA, MO 65203-1113
(573) 356-4071
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/08/2015
Last updated
11/08/2015
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