Individual
MR. ISSAC JAMES WOODFORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5157 WHALEY DR, DAYTON, OH 45417-8248
(937) 750-6767
Mailing address
5157 WHALEY DR, DAYTON, OH 45417-8248
(937) 750-6767
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812808850
—
OH
Enumeration date
11/04/2022
Last updated
11/04/2022
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