Individual
NAN L WOODBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Mailing address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2242
TN
Other
Enumeration date
03/06/2008
Last updated
09/15/2008
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